[Well informed? Survey results on individual out-of-pocket health services in selected GP practices]

Z Evid Fortbild Qual Gesundhwes. 2019 May:141-142:45-52. doi: 10.1016/j.zefq.2019.03.006. Epub 2019 May 1.
[Article in German]


Objectives: Patients have to pay out of their own pocket for individual medical services (in German: Individuelle Gesundheitsleistungen, IGeL). The benefit of many IGeL is controversial. Hence, well-founded patient information and counselling are important. For this purpose, several medical organizations and associations developed a checklist including 10 criteria concerning legal and content aspects. Based on this checklist, this study examined how well patients feel informed about IGeL by their doctors. Additionally, we assessed the utilization of IGeL and the attitude of physicians towards IGeL.

Methods: A questionnaire was distributed to 1,000 patients in 20 GP practices in Germany. The data of the patient survey was analyzed descriptively.

Results: The response rate to the patient survey was 92.9 %. Of 923 patients, 38 % used at least one IGeL in the last 12 months. The most common IGeL were ultrasound examinations (34 %). Differences were found in compliance with the criteria checklist: In most cases, patients received an invoice (79 %), ad-free information (70 %) and explanations of the medical necessity of the IGeL (70 %). However, physicians have failed to meet these criteria in more than a fifth of respondents. Also, physicians rarely refer to other requirements of the checklist such as, for example, further information and the possibility of obtaining a second opinion.

Conclusion: This non-representative survey indicates that many patients make use of IGeL. However, they are often not well advised. Physicians should consider criteria of the checklist more rigorously.

Keywords: Anforderungen; Beratung; Individuelle Gesundheitsleistungen (IGeL); Patientenbefragung; Transparenz; consultation; individual out-of-pocket health services; patient survey; standards; transparency.

MeSH terms

  • General Practice*
  • Germany
  • Health Care Costs*
  • Humans
  • Referral and Consultation*
  • Surveys and Questionnaires