OBJECTIVES: The provision of self-pay medical services is common across health care systems, but understudied. According to the German Medical Association, such services should be medically necessary, recommended or at least justifiable, and requested by the patient. We investigated the empirical evidence regarding frequency and practice of self-pay services as well as related ethical, social, and legal issues (ELSI). METHODS: A systematic literature search in electronic databases and a structured internet search on stakeholder websites with qualitative and quantitative information synthesis. RESULTS: Of 1,345 references, we included 64 articles. Between 19 and 53 % of insured persons received self-pay service offers from their physician; 16-19 % actively requested such services. Intraocular pressure measurement was the most common service, followed by ultrasound investigations. There is a major discussion about ELSI in the context of individual health services. CONCLUSIONS: Self-pay services are common medical procedures in Germany. However, the empirical evidence is limited in quality and extent, even for the most frequently provided services. Transparency of their provision should be increased and independent evidence-based patient information should be supplied.
OBJECTIVES: The provision of self-pay medical services is common across health care systems, but understudied. According to the German Medical Association, such services should be medically necessary, recommended or at least justifiable, and requested by the patient. We investigated the empirical evidence regarding frequency and practice of self-pay services as well as related ethical, social, and legal issues (ELSI). METHODS: A systematic literature search in electronic databases and a structured internet search on stakeholder websites with qualitative and quantitative information synthesis. RESULTS: Of 1,345 references, we included 64 articles. Between 19 and 53 % of insured persons received self-pay service offers from their physician; 16-19 % actively requested such services. Intraocular pressure measurement was the most common service, followed by ultrasound investigations. There is a major discussion about ELSI in the context of individual health services. CONCLUSIONS: Self-pay services are common medical procedures in Germany. However, the empirical evidence is limited in quality and extent, even for the most frequently provided services. Transparency of their provision should be increased and independent evidence-based patient information should be supplied.
Authors: Gerd Gigerenzer; Wolfgang Gaissmaier; Elke Kurz-Milcke; Lisa M Schwartz; Steven Woloshin Journal: Psychol Sci Public Interest Date: 2007-11-01
Authors: Saundra S Buys; Edward Partridge; Mark H Greene; Philip C Prorok; Douglas Reding; Thomas L Riley; Patricia Hartge; Richard M Fagerstrom; Lawrence R Ragard; David Chia; Grant Izmirlian; Mona Fouad; Christine C Johnson; John K Gohagan Journal: Am J Obstet Gynecol Date: 2005-11 Impact factor: 8.661
Authors: Usha Menon; Aleksandra Gentry-Maharaj; Rachel Hallett; Andy Ryan; Matthew Burnell; Aarti Sharma; Sara Lewis; Susan Davies; Susan Philpott; Alberto Lopes; Keith Godfrey; David Oram; Jonathan Herod; Karin Williamson; Mourad W Seif; Ian Scott; Tim Mould; Robert Woolas; John Murdoch; Stephen Dobbs; Nazar N Amso; Simon Leeson; Derek Cruickshank; Alistair McGuire; Stuart Campbell; Lesley Fallowfield; Naveena Singh; Anne Dawnay; Steven J Skates; Mahesh Parmar; Ian Jacobs Journal: Lancet Oncol Date: 2009-03-11 Impact factor: 41.316
Authors: Saundra S Buys; Edward Partridge; Amanda Black; Christine C Johnson; Lois Lamerato; Claudine Isaacs; Douglas J Reding; Robert T Greenlee; Lance A Yokochi; Bruce Kessel; E David Crawford; Timothy R Church; Gerald L Andriole; Joel L Weissfeld; Mona N Fouad; David Chia; Barbara O'Brien; Lawrence R Ragard; Jonathan D Clapp; Joshua M Rathmell; Thomas L Riley; Patricia Hartge; Paul F Pinsky; Claire S Zhu; Grant Izmirlian; Barnett S Kramer; Anthony B Miller; Jian-Lun Xu; Philip C Prorok; John K Gohagan; Christine D Berg Journal: JAMA Date: 2011-06-08 Impact factor: 157.335