Nohl-Deryk Pascal, Scherer Martin
Institut für Allgemeinmedizin, Universität zu Köln Medizinische Fakultät, Köln, Germany.
Institut für Allgemeinmedizin, Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Gesundheitswesen. 2023 Nov;85(11):1004-1009. doi: 10.1055/a-1974-8606. Epub 2023 Jan 24.
Despite statewide rising numbers of family physicians during the last legislative period, their overall health care providing capacity has declined, mainly due to their working part-time. In the legislative period starting in 2021, this trend appears likely to continue. The German Health System Advisory Council foresees the number of general practitioners (GPs) who will have to be replaced by the next federal election in 2025 as exceeding 26,000. This results in a need for political action to sustain the primary care workforce.
We conducted a content analysis of the coalition agreement 2021 between SPD, Greens and FDP with regard to explicit and related topics of GP care. A mixed inductive-deductive classification of the included text passages was used to thematically structure the results.
A total of 34 relevant text passages were identified between pages 8 to 139 of the coalition agreement. Family physician care was explicitly addressed only once, when the planned abolition of budgeting was discussed. Other proposals which affect family physicians work included reduction of bureaucracy, prevention, or easier access to medical care for disadvantaged groups. Other passages of the coalition agreement regarding security of medical supply, included demand planning, innovative healthcare models, and cross-sectoral care. One focus of the coalition agreement was on digitalization. It mentions e. g., a digitization strategy for the healthcare sector, telemedicine services, and the electronic medical record, including opt-out possibility. Other assessed passages included projects to facilitate research or climate change and health.
Despite the lack of mention of family physicians in the coalition agreement, many projects relate to the work of family physicians. Some of the ideas mentioned have also already been written down by the German Society for General Practice and Family Medicine (DEGAM) in its positions on the future of general practice, digitization or climate change and health. The planned projects in the coalition agreement have the potential to strengthen health care by family doctors and also make it more attractive for young doctors. However, further measures may be necessary to maintain GP care in the short and long term.
尽管在上一个立法期间该州家庭医生数量不断增加，但其整体医疗服务提供能力却有所下降，主要原因是他们从事兼职工作。在始于2021年的立法期间，这一趋势似乎可能会持续下去。德国卫生系统咨询委员会预计，到2025年下一次联邦选举时，需要更换的全科医生数量将超过26000人。这就需要采取政治行动来维持基层医疗劳动力。
我们对社民党、绿党和自民党之间的2021年联合协议中有关全科医生护理的明确及相关主题进行了内容分析。对所纳入的文本段落采用归纳 - 演绎混合分类法对结果进行主题结构化。
在联合协议的第8页至139页之间共确定了34条相关文本段落。仅在讨论计划废除预算编制时明确提到了家庭医生护理。其他影响家庭医生工作的提议包括减少官僚作风、预防工作或使弱势群体更容易获得医疗服务。联合协议中关于医疗供应安全的其他段落包括需求规划、创新医疗模式和跨部门护理。联合协议的一个重点是数字化。例如，它提到了医疗保健部门的数字化战略、远程医疗服务和电子病历，包括选择退出的可能性。其他评估段落包括促进研究或气候变化与健康的项目。
尽管联合协议中未提及家庭医生，但许多项目与家庭医生的工作相关。德国全科与家庭医学协会（DEGAM）在其关于全科医学未来、数字化或气候变化与健康的立场中也已经阐述了一些上述提到的想法。联合协议中规划的项目有可能加强家庭医生的医疗服务，也使其对年轻医生更具吸引力。然而，可能需要进一步措施来在短期和长期维持全科医生护理。
