Jan Bauer 1 , Werner Maier 2 , Ruth Müller 1 , David A Groneberg 1 Show Affiliations »
Abstract
BACKGROUND: Access to primary care plays an important role in medical care provision in Germany. Therefore, current health care planning aims at providing equal access for every patient in Germany no matter where they live. OBJECTIVE: This study examined accessibility of primary care and compared the result with current primary care planning data. MATERIALS AND METHODS: Spatial accessibility to primary care was measured by the integrated Floating Catchment Area method ("accessibility index") using a geographical information system at the level of square kilometers cells (hectare grid cells for major urban areas). RESULTS: The analysis of 649 million generated records showed considerable geographical variations of accessibility: 4.7 % of the total population lived in areas with significantly lower primary care accessibility (z-score = -3.4), whereas 48.0 % of the population lived in areas with significantly higher primary care accessibility (z-score = 9.7). The average accessibility index was 0.14 (SD = 0.15) and increased the more urban (r = 0.64; p < 0.001) and the less deprived (r = -0.37; p < 0.001) the area was. Within health care planning regions, the accessibility index varied by an average of Δ = 0.23 (SD = 0.19) and was not correlated with the degree of care provision (r = -0.04; p = 0.28). CONCLUSION: With regard to primary care, there are urban-rural disparities and regional social inequalities in Germany. Therefore, health care planning should take greater account of spatial accessibility in the future. © Georg Thieme Verlag KG Stuttgart · New York.
BACKGROUND: Access to primary care plays an important role in medical care provision in Germany. Therefore, current health care planning aims at providing equal access for every patient in Germany no matter where they live. OBJECTIVE: This study examined accessibility of primary care and compared the result with current primary care planning data. MATERIALS AND METHODS: Spatial accessibility to primary care was measured by the integrated Floating Catchment Area method ("accessibility index") using a geographical information system at the level of square kilometers cells (hectare grid cells for major urban areas). RESULTS: The analysis of 649 million generated records showed considerable geographical variations of accessibility: 4.7 % of the total population lived in areas with significantly lower primary care accessibility (z-score = -3.4), whereas 48.0 % of the population lived in areas with significantly higher primary care accessibility (z-score = 9.7). The average accessibility index was 0.14 (SD = 0.15) and increased the more urban (r = 0.64; p < 0.001) and the less deprived (r = -0.37; p < 0.001) the area was. Within health care planning regions, the accessibility index varied by an average of Δ = 0.23 (SD = 0.19) and was not correlated with the degree of care provision (r = -0.04; p = 0.28). CONCLUSION: With regard to primary care, there are urban-rural disparities and regional social inequalities in Germany. Therefore, health care planning should take greater account of spatial accessibility in the future. © Georg Thieme Verlag KG Stuttgart · New York.
Entities: Species
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Year: 2017
PMID： 28915518 DOI： 10.1055/s-0043-110846
Source DB: PubMed Journal: Dtsch Med Wochenschr ISSN： 0012-0472 Impact factor: 0.628