一般医生的空间和时间差异:德国下萨克森州的21年纵向分析
Jonas Schoo1, Frank Schüssler2
1Department of Civil Engineering Geoinformation Health Technology, Jade University of Applied Sciences, Oldenburg, Germany. jonas.schoo@jade-hs.de.
International journal of health geographics
|December 4, 2025
概括
农村地区面临全科医生 (GP) 供应的下降,主要是由于医生退休,加剧了城市和农村的健康不平等. 需要有针对性的战略来应对这一初级保健准入挑战.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 空间流行病学 空间流行病学
- 公共卫生政策 公共卫生政策
背景情况:
- 公平获得全科医生 (GP) 服务对于减少健康不平等至关重要,特别是在城市和农村地区之间.
- 了解初级保健提供动态对于有效的医疗保健规划和政策制定至关重要.
- 在全科医生服务获取方面持续存在的挑战会影响卫生系统的公平性.
研究的目的:
- 评估2000-2021年德国下萨克森州GP供应的空间和时间差异.
- 分析市级初级保健可及性和可用性的趋势.
- 为了确定GP分布变化的驱动因素.
主要方法:
- 利用了法定医疗保险医生协会和市政人口统计数据的数据.
- 开发了全科医生区域指数 (GPRI) 来衡量全科医生可用性和可访问性.
- 应用非参数统计测试以确定市级显著趋势.
主要成果:
- 在GP供应方面发现了显著的地理不平等,超过40%的人口生活在供应下降的地区.
- 城市中心和郊区保持了更高,稳定的GP供应,而农村地区显示出更低的可访问性和负面趋势.
- 医生退休是供应损失的主要原因,由于迁移而造成的再分配有限.
结论:
- 在全科医生可用性方面,城市和农村的差异仍然存在,主要是由于医生退休.
- 医生移民的影响有限,但无法抵消农村地区的损失.
- 需要针对空间的劳动力战略和创新的初级保健模式来改善农村GP供应和健康公平.
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