NWIn (Netzwerk Inanspruchnahme gesundheitsbezogener Leistungen in Deutschland/Health Care Utilization in Germany): Summary of the Results-Chapter

First Birgit Babitsch and Cornela Bormann give an overview on gender and health care use. Picking up one, if not the key explanatory factor from a medical sociology viewpoint, Jens Klein, Kerstin Hofreuter-Gätgens, and Olaf von dem Knesebeck systematically review the associations of socioeconomic status and health care utilization in Germany. The review indicate that the strongest inequalities exist in the area of prevention, in that the lower the social status, the less people utilize prevention or early detection programs. Subsequently, Cristina Carmen Ciupitu-Plath, Daniela Gohl, and Birgit Babitsch give an overview on migration and health care utilization in the European context. Next, Daniel Lüdecke, Eva Mnich, and Christopher Kofahl discuss that home care and support of dependent elderly people are primarily provided by relatives, friends, or close acquaintances. Predisposing and need factors turn out to be most relevant to explaining family caregivers‘ attitudes and opinions regarding service utilization as well as and service utilization itself. Two major burdens of disease in the decades ahead will be dementia and obesity. Thus Elmar Gräßel and colleagues, present two timely studies on predictors of the use of care and support services, the use of non-drug therapies, and the use of health and care services by community-dwelling persons with dementia and their family caregivers. Overall, predisposing factors such as patient age as well as caregiver age or education level are not as consistently predictive as the need for a service. Regarding obesity, Thomas von Lengerke and colleagues provide a systematic review based on population studies on the obesity-associated utilization of outpatient primary care physician care by adults in Germany, and they empirically examine the associations between moderate and severe obesity on the one hand and the utilization of outpatient general practitioner care on the other. Finally, Holm Thieme and Bernhard Borgetto look at rheumatic diseases and, in this context, at the use of physiotherapists as a relevant allied health profession (H. Thieme and B. Borgetto) and the participation in self-help activities as an important part of the lay health care system (B. Borgetto and H. Thieme). Mirjam Körner, Birte Maschke, and Christian Janßen examine psychotherapy as a field gaining in importance for the health care system as the rate of mental disorders in Germany increases. All studies included show that patients with a higher level of education often have better access to psychotherapy than those with a lower level, although the latter more commonly suffer from mental disorders. Following this, Christoph Kowalski and colleagues focus on the field of disease prevention and health promotion. Most of the analyzed studies provide quite clear evidence of an association between higher social status, female gender, and non-migrant status on one hand and the use of prevention or health promotion services on the other. Finally, Achim Siegel and Ulrich Stößel report results of an integrated care study that is well-known in Germany, namely „Gesundes Kinzigtal Integrated Care” (Healthy Kinzigtal Integrated Care [GKIC]). It represents one of the few population-based integrated care systems in Germany.