Inpatient Endometriosis Care in Germany: Hospital Caseloads and their Spatial Distribution
Lara Brauer1, Limei Ji1, Max Geraedts1
1Institut für Gesundheitsversorgungsforschung und Klinische Epidemiologie, Philipps-Universität Marburg, Fachbereich 20 Medizin, Marburg, Germany.
Background:
Endometriosis is a chronic gynaecological disease with an estimated prevalence of 10-15%. The German guideline provides evidence-based recommendations for diagnosis and treatment, but care provided is inadequate care due to long diagnostic pathways. Recent German research focused on regional variations in outpatient care, however research on inpatient endometriosis care is still lacking.
Aim Of The Study:
The aim of the study was to examine inpatient endometriosis care - hospital locations and their caseloads. Spatial coverage, caseload distribution patterns and possible clusters, including certified endometriosis centres (CEC) and non-certified hospitals nationwide were analysed.
Method:
German hospital quality report data from 2021 was used as data source. The location, certification status and caseload, meaning coded ICD-10 N80 Endometriosis cases, were collected for all hospitals. Then, 20-, 40- and 60-minutes' drive radius of CEC and non-certified hospitals were determined. Global and Local Moran's I was calculated to assess spatial clusters in caseload.
Results:
A CEC 60-minutes' drive radius covers 78.15% of the area in Germany. Including all hospital locations that coded endometriosis, a maximum driving time of 40-minutes provides almost nationwide coverage. High caseload clusters appeared in urban areas and low caseload clusters especially in eastern Germany.
Conclusion:
The results indicate spatial clusters in providers caseload and difficulties in access to CEC for patients depending on location. Further research with patient-level data is needed to investigate the spatial distribution of patients and precise travel time for inpatient care.
