Imbalanced access to pediatric primary care in Switzerland: geographic differences and modeled future challenges

The purpose of this study is to determine the number, age, geographic distribution, and accessibility of primary care pediatricians (PCP) in Switzerland, and to model the regional need for substitutions of soon-to-retire PCPs 5 years from now. We conducted a population-based study applying the floating catchment area method (Modified Huff-model-based Variable 3 Step Floating Catchment Area, MHV3SFCA) to calculate supply density indices (SDI) and produced accessibility maps based on data on PCP of the Federal Statistical Office (FSO) and the spatial data set of the statistics on population and households (STATPOP). In 2019, 1332 PCPs were working in pediatric practices in Switzerland (average workload: 70.4%), caring for 1,335,177 children and adolescents under the age of 15 years (i.e., 1423 per PCP). We found significant regional differences: less than 60% of the recommended PCP density, particularly in the northern part of the country and in rural regions. The needed workforce is going to accentuate markedly until 2029, when around 1/4 of Swiss pediatricians currently working in private practices will be retired. Conclusion: We provided a detailed analysis of the spatial distribution of PCP in Switzerland and a simulation model of the demand within the next years based on expected retirements. Our findings show current geographic disparities in pediatric primary care provision, which will accentuate and lead to a PCP shortage in many regions of Switzerland in the near future. Without sufficient compensation, adaptations of pediatric healthcare models need to be considered to avoid dramatic underservice. Our methodology is applicable to many comparable settings worldwide. What is known: • pediatric care in many countries is challenged by impending retirement of older pediatric primary care providers • suitable statistical models are needed to identify the spatial distribution of current and future demand What is new: • We visualized regional differences in the accessibility of paediatric primary care in Switzerland at a small-scale level, and the spatial distribution of places in need of a replacement by 2029 • Our model is applicable to other regions, countries, and disciplines.