Determinants of Frequent Attendance of Outpatient Physicians: A Longitudinal Analysis Using the German Socio-Economic Panel (GSOEP)

There is a lack of population-based longitudinal studies which investigates the factors
leading to frequent attendance of outpatient physicians. Thus, the purpose of this study was to
analyze the determinants of frequent attendance using a longitudinal approach. The used dataset
comprises seven waves (2002 to 2014; n = 28,574 observations; ranging from 17 to 102 years) from
the nationally representative German Socio-Economic Panel (GSOEP). The number of outpatient
physician visits in the last three months was used to construct the dependent variable “frequent
attendance”. Dierent cut-os were used (top 25%; top 10%; top 5%). Variable selection was based
on the “behavioral model of health care use” by Andersen. Accordingly, variables were grouped
into predisposing, enabling, and need characteristics as well as health behavior, which are possible
determinants of frequent attendance. Conditional fixed eects logistic regressions were used. As for
predisposing characteristics, regressions showed that getting married and losing one’s job increased
the likelihood of frequent attendance. Furthermore, age was negatively associated with the outcome
measure. Enabling characteristics were not significantly associated with the outcome measure, except
for the onset of the “practice fee”. Decreases in mental and physical health were associated with an
increased likelihood of frequent attendance. Findings were robust across dierent subpopulations.
The findings of this study showed that need characteristics are particularly important for the onset of
frequent attendance. This might indicate that people begin to use health services frequently when
medically indicated.