[Travel times of patients to ambulatory care physicians in Germany]. / Zurückgelegte Wegzeiten in der ambulanten ärztlichen Versorgung in Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
; 60(12): 1383-1392, 2017 Dec.
Article
em De
| MEDLINE
| ID: mdl-29075812
ABSTRACT
BACKGROUND:
The time needed by patients to get to a doctor's office represents an important indicator of realised access to care. In Germany, findings on travel times are only available from surveys or for some regions.OBJECTIVE:
For the first time, this study examines nationwide and physician group-specific travel times in the ambulatory care sector in Germany and describes demographic, supply-side and spatial determinants of variations.METHODS:
Using a full review of patient consultations in the statutory health insurance system from 2009/2010 for 14 physician groups (approximately 518 million cases), case-related travel times by car between patients' places of residence and physician's practices were estimated at the municipal level.RESULTS:
Physicians were reached in less than 30 min in 90.8% of cases for primary care physicians and up to 63% of cases for radiologists. Patients between 18 and under 30 years of age travel longer to get to the doctor than other age groups. The average travel time at the county level systematically differs between urban and rural planning areas. In the case of gynecologists, dermatologists and ophthalmologists, the average journey time decreases with increasing physician density at the county level, but remains approximately constant from a recognisable point of inflection. There is no association between primary care physician density and travel time at the district level. Spatial analyses show physician group-specific patterns of regional concentrations with an increased proportion of cases with very long travel times.CONCLUSION:
Patients' travel times are influenced by supply- and demand-side determinants. Interactions between influential determinants should be analysed in depth to examine the extent to which the time travelled is an expression of regional under- or over-supply rather than an expression of patient preferences.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Médicos
/
Viagem
/
Serviços Contratados
/
Assistência Ambulatorial
/
Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Qualitative_research
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
De
Revista:
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
Assunto da revista:
SAUDE PUBLICA
Ano de publicação:
2017
Tipo de documento:
Article