Regional variations in multimorbidity burden among office-based physicians in Germany

Area of Science:

• Health Services Research
• Public Health Policy
• Epidemiology

Background:

• Multimorbidity significantly increases healthcare service utilization.
• Current physician supply estimations often overlook multimorbidity's impact.
• Accurate physician workforce planning requires incorporating regional health complexities.

Purpose of the Study:

• To assess the integration of regional multimorbidity levels in estimating office-based physician supply.
• To analyze how multimorbidity prevalence varies across different physician specialties.
• To compare physician distribution with areas of high multimorbidity.

Main Methods:

• Utilized claims data to identify and quantify multimorbid patients across General Practitioners (GPs), ophthalmologists, orthopaedic specialists, and neurologists.
• Employed Bernoulli cluster analysis to map spatial variations in regional multimorbidity.
• Compared identified high-rate multimorbidity clusters with existing physician supply data.

Main Results:

• Approximately 17.2 million individuals (25.7%) were classified as multimorbid.
• Multimorbidity prevalence ranged from 31.5% to 60.1% across physician disciplines.
• Over one-third of high-GP-multimorbidity clusters faced supply below target levels, while high-specialist-multimorbidity clusters often exceeded supply targets.

Conclusions:

• Developed a novel approach for integrating discipline-specific multimorbidity into area-level physician supply estimations.
• Findings highlight potential undersupply of GPs in high-need areas and oversupply of specialists.
• Recommendations provided for policymakers to enhance healthcare planning and improve office-based care quality.