Stock C, Szecsenyi J, Riedinger-Riebl U, Steinhäuser J
Institut für Medizinische Biometrie und Informatik, Universitätsklinikum Heidelberg, Heidelberg.
Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Heidelberg.
Gesundheitswesen. 2015 Dec;77(12):939-46. doi: 10.1055/s-0034-1398605. Epub 2015 Mar 11.
Within the next 8 years about 2 000 general practitioners (GPs) will be seeking a successor in the federal state of Baden-Württemberg, Germany. Both the small number of newly qualified GPs and the wish to work as an employee or in a group practice will lead to a situation in which about 500 practices will likely not find a successor. Using a single administrative district, the aim of this analysis was to develop a projection of the demand for GP health care at the community level.
Using the administrative district of Rottweil with its 21 communities, a community-based demographic forecast on the basis of current birth and death probabilities was performed. From the projected population structure, the demand for GP care in the year 2023 was derived under the assumption of unchanged age- and gender-specific numbers of GP visits. The anticipated deficit or, respectively, overrun of GPs at the community level was calculated as the difference between expected demand and number of GPs not retiring for age-related reasons.
Until the year 2023 the demographic change will cause a shrinking population. However, with unchanged age- and gender-specific numbers of GP visits, a slightly higher demand of 0.6 GPs will occur as a result of population-aging. The expected age-related retirement of physicians will have a stronger impact on primary care demand than demography. Up to 32 (37%) GPs might need a successor. In addition to 4 communities today, this would result in another 5 communities not having a GP in 10 years.
Communities that are at higher risk of GP shortage based on demographic changes and age of practicing GPs, can be identified by the approach described and applied here in order to implement targeted comprehensive community models of care.
在未来8年内,德国巴登-符腾堡州约2000名全科医生(GP)将寻求继任者。新获得资格的全科医生数量较少,以及希望成为雇员或在团体诊所工作的意愿,将导致约500家诊所可能找不到继任者的情况。本分析旨在通过一个行政区,对社区层面的全科医疗需求进行预测。
以拥有21个社区的罗特韦尔行政区为基础,根据当前的出生和死亡概率进行了基于社区的人口预测。从预测的人口结构出发,在假设特定年龄和性别的全科医生就诊人数不变的情况下,得出了2023年的全科医疗需求。社区层面全科医生的预期短缺或超额数量,计算为预期需求与因年龄相关原因未退休的全科医生数量之间的差值。
到2023年,人口结构变化将导致人口减少。然而,在特定年龄和性别的全科医生就诊人数不变的情况下,人口老龄化将导致需求略有增加,多出0.6名全科医生。医生预期的年龄相关退休对初级医疗需求的影响将大于人口结构变化。多达32名(37%)全科医生可能需要继任者。除了目前的4个社区外,这将导致另外5个社区在10年后没有全科医生。
基于人口结构变化和执业全科医生年龄,有更高全科医生短缺风险的社区,可以通过本文所述及应用的方法来识别,以便实施有针对性的综合社区护理模式。