Identification of Hard to Serve Regions in the Primary Healthcare Provision: the Example of Lower Saxony
DOI: 10.3238/zfa.2016.0161-0166german translation / full article
Background: In times of demographic change and increasing inequalities in the availability of primary care providers among urban and rural areas, it becomes more difficult to ensure primary care provision in Germany. The current needs-based planning only encompasses a small number of different criteria which influence the healthcare situation. The aim of this study is to identify further criteria to identify hard to serve regions.
Methods: A literature search was applied to identify further criteria which influence the healthcare situation and which are internationally used in needs-based planning. Based on these criteria, hard to serve regions can be identified. Lower Saxony is used as an example for this identification.
Results: The identified criteria can be classified into four different categories: Physician-to-population ratio, demography, geography and socioeconomics. First, among all rural areas of Lower Saxony, those are selected for which the predicted primary healthcare provision appears worst. Exemplarily, a joint community is identified as hard to serve region based on a regional analysis of the criteria identified above.
Conclusions: The criteria, which are used to identify hard to serve regions can supplement the current needs-based planning. Thus, hard to serve regions can be identified at an early stage and new models of care can be implemented.