Innovative Models for Securing Health Care in Rural Areas

DOI: 10.3238/zfa.2020.0198-0202

german translation / full article

Anne Berghöfer, Carolin Auschra, Jana Deisner, Jörg Sydow

Keywords: context design health care model organisational form rural area

BackgroundSecuring health care in rural areas is becoming increasingly difficult. In the meantime, a variety of models and measures has been developed to ensure the long-term provision of health care in rural areas beyond the scope of traditional planning by the association of statutory health insurance physicians.MethodsUsing systematic research in different databases and selected medical journals, innovative models for health care in rural areas in Germany were identified and systematised from an organisational point of view. In 33 interviews with 35 selected experts, barriers and facilitators for the development and implementation of the models were explored and potentials for their use were identified. The interviews were qualitatively analysed and the results triangulated with literature and documents.Results90 models in the outpatient or inpatient sector, cross-sectoral, or context measures were identified. The largest part used classical or newer (medical care centre) practice organisation forms and combined these with design elements such as delegation, telemedicine, mobility, networking or supporting context measures. Implementation experiences and perceived barriers arose at the level of the model, in the local environment and at the level of the health system. ConclusionsNone of the models can yet be regarded as a blueprint for solving health care problems in rural areas. Changed forms of activity in the medical profession (part-time work, employment contracts, networking), distance-bridging solutions (telemedicine) and inter-professional cooperation (networking, delegation) have potential. The expansion of management competencies for work with and within complex models and the prospect of transfer to standard care when the effectiveness of innovative models has been scientifically proved is necessary.Keywordshealth care model; rural area; organisational form; context design

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