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Access to Neurosurgery for Patients in Germany-Strategic Considerations Based on Geographic Information Mapping
Rosita Rupa1, Anastasios Tsogkas2, Dalibor Bockelmann3
1Department of Neurosurgery, Marburg University Hospital, Baldinger Str., 35043 Marburg, Germany.
Clinics and Practice
|February 26, 2026
Summary
Access to neurosurgery in Germany is linked to population density. Geographic mapping reveals disparities, particularly in eastern federal states, highlighting needs for targeted healthcare improvements.
Area of Science:
- Healthcare access research
- Medical geography
- Public health policy
Background:
- Upcoming German healthcare reform necessitates evaluating current neurosurgical access.
- Geographic disparities in healthcare access require investigation for targeted improvements.
Purpose of the Study:
- To estimate neurosurgical access across Germany using geographic mapping.
- To identify strategies for improving neurosurgical care access.
- To inform regional healthcare policies based on spatial analysis.
Main Methods:
- Defined access to neurosurgery (A2N40) as reachability within 40 minutes by car.
- Utilized open-source population and geodetic data for 182 neurosurgical departments.
- Performed statistical analyses in R, including correlation and rank sum tests.
Main Results:
- A significant positive correlation exists between population density and A2N40 per square kilometer (Spearman's rho = 0.82, p = 0.0001).
- New federal states (excluding Berlin) show significantly lower population density and worse A2N40 per square kilometer compared to other regions.
- Geographic mapping identified three distinct strategies for enhancing neurosurgical access.
Conclusions:
- Neurosurgical access in Germany correlates positively with population density.
- Significant access disparities exist, with eastern federal states facing greater challenges.
- Geographic information mapping provides a valuable tool for developing tailored regional healthcare improvement policies.
