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The authors do recognize that "[t]hese strategies for avoiding physician reporting are not the best solution," but they do not back off of them.
As has been discussed above, the prevalence for delaying or avoiding physician visits changes considerably between the six waves.
This study looks at the effect of this new patient fee on delaying or avoiding physician visits, with a special emphasis on different income groups.
Concerning the independent variable of primary importance here, i.e. income, the bivariate analyses clearly show that delaying or avoiding physician visits is reported most often in the lowest income group (see Figure 3).
Another explanation may be that avoiding physician lay-offs is a strategy to reduce resistance to change by compensating physicians for coping with the organizational adjustments associated with privatization.
The final objective should be to analyse the health effects of delaying or avoiding physician visits, and this will only be possible with a better assessment of the need to see a physician, and with follow up information on health.
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This suggests that those who would avoid physician visits were also more likely to avoid early medical testing.
To avoid physician referral bias we also compared the referral sources of ASD children evaluated by the pediatric neurologist and by those of other specialists of the Autism Center.
Our study hypothesis is that patients who are socio-economically disadvantaged will delay or even avoid physician visits to a larger extent than patients with more favourable socio-economic backgrounds.
The prevalence of 'delayed or avoided physician visits' increased from 35.8% in spring 2004 to 46.8% about six months later, stayed high until spring 2006 and decreased to 35.7% in autumn 2006.
Participants with less than €6000 are about 2.3 times more likely to delay or avoid physician visits than those with more than €1,3000 (model 1, OR = 2.31, CI 1.98 2.70, β = 0.84, se = 0.08).
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