Objective: To identify overall levels of health system responsiveness and the associations with social determinants for ambulatory health care in Germany from a user perspective.
Methods: This analysis drew on a 2016 health survey sample of 6113 adults in Germany. Responsiveness was measured for general practitioners (GPs) and specialists (SPs) along the domains trust, dignity, confidentiality, autonomy and communication. Bivariate and multivariate logistic regression techniques were applied.
Results: Over 90% of all patients assessed their last GP and SP visit as good regarding trust, dignity, autonomy and communication, but only half for confidentiality in the doctor office (GP visits: 50.3%; SP visits: 52.4%). For GP visits, patients' young age of 18-34 years showed most associations with poor assessment of the domains, for SP visits a current health problem as the reason for the last consultation.
Conclusion: While overall responsiveness levels for ambulatory care are high, ratings of confidentiality are distressing. Particularly patients' young age and bad health are associated with a poor assessment of responsiveness.
Practice implications: Measures to improve doctor office infrastructure and to enhance responsiveness towards patients under the age of 35 years and those with health problems are vital to increase responsiveness.
Keywords: Ambulatory care; General practitioners; Germany; Health equity; Health survey; Health system responsiveness; Social determinants; Specialists.
Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.