[Trends in the utilization of outpatient medical care in childhood and adolescence: results of the KiGGS study - a comparison of baseline and first follow up (KiGGS Wave 1)]. / Trends in der Inanspruchnahme ambulant-ärztlicher Leistungen im Kindes- und Jugendalter : Ergebnisse der KiGGS-Studie - Ein Vergleich von Basiserhebung und erster Folgebefragung (KiGGS Welle 1).

This article provides information on trends in the utilization of outpatient medical care in childhood and adolescence in Germany on the basis of data from two waves of the KiGGS study (prevalences and odds ratios). In the period 2009-2012, 91.9% (95% CI 91.1-92.7%) of children and adolescents used outpatient medical services at least once a year. In the 12 months prior to the interview, 67.9% (95% CI 65.9-69.8%) of the 0- to 17-year-olds consulted a pediatrician and 34.1% (95% CI 31.6-36.3%) a general practitioner. Whereas there was no change in the use of either overall outpatient or general practice medical care compared to 2003-2006, a significant increase of 8.7% points in the utilization of pediatricians was found. This could be explained by, among other factors, an expansion of pediatric services (additional vaccinations and health screening examinations) in recent years. It may also be related to a significantly greater participation in the health screening program in early childhood (U3-U9 examinations), which was seen especially when comparing the youngest birth cohorts and in children from families with low social status (from U7 onwards). The increased use of health screening examinations can probably be attributed to the invitation, reminding and reporting procedures that have been introduced in recent years. Whereas at KiGGS baseline urban-rural differences in participation in health screening examinations could be seen, these were no longer apparent in KiGGS Wave 1. Similarly, differences between rural and urban regions in the use of general and pediatric medical services have also diminished. Nevertheless, currently children and young people in rural areas use outpatient general medical care to a greater extent than those in urban areas.

[Utilization of outpatient and inpatient health services in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. / Inanspruchnahme der ambulanten und stationären medizinischen Versorgung in Deutschland: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).

The article provides representative benchmarks and trends for the use of medical and therapeutic services in Germany on the basis of the German Health Interview and Examination Survey for Adults (DEGS1) and the German National Health Interview and Examination Survey 1998 (GNHIES98) from the years 2008-2011 and 1997/98, respectively. DEGS1 shows that women seek most medical services more often than men. Differences by gender decreased with age. In almost all services, an increase in utilisation is recorded with age. There are large differences in utilisation depending on self-rated health, as opposed to fewer differences by social status, health insurance and region. At both time points, the proportion of the population that utilised outpatient or inpatient medical assistance at least once a year, is almost unchanged high. At the same time, a significant reduction in the annual number of contacts with medical practices and the length of hospital stay was recorded as well as an increase of the consulted specialist groups. This may be explained due to regulation effects of earlier reforms. An English full-text version of this article is available at SpringerLink as supplemental.