[Regional differences between general practitioners and general internal medicine physicians in primary care]

Area of Science:

• Medical Science
• Public Health
• Healthcare Management

Background:

• Increasing demand for primary care physicians in Germany, particularly in rural regions.
• Hypothesis that broad vocational training influences physicians' rural practice decisions.
• Distinct training schemes for General Practitioners (GPs) and General Internal Medicine (GIM) physicians may affect regional distribution and practice patterns.

Purpose of the Study:

• To analyze differences in regional distribution between GPs and GIM physicians in Schleswig-Holstein, Germany.
• To compare the rate and frequency of home visits performed by GPs and GIM physicians.
• To investigate whether training breadth impacts practice location and service provision in rural areas.

Main Methods:

• Analysis of invoicing data from the Association of Statutory Health Insurance Physicians in Schleswig-Holstein (2015-2018).
• Comparison of regional distribution (urban vs. rural) between GPs and GIM physicians.
• Assessment of home visit rates, frequency, and unforeseen physician visits using bivariate and multivariate regression analyses.

Main Results:

• GPs were significantly more likely to practice in rural areas (27.5%) compared to GIM physicians (14.5%).
• GPs performed home visits more frequently than GIM physicians (97.8% vs. 93.2%), with a more pronounced difference in rural areas.
• GPs conducted 36% more home visits than GIM physicians overall, and 60% more in rural areas.

Conclusions:

• Significant differences exist between GPs and GIM physicians in regional practice location and home visit frequency.
• GPs demonstrate a stronger presence in rural areas and a higher rate of home visits.
• Findings suggest a need to explore how GIM physicians can be better equipped for primary care roles, especially in underserved rural regions.