Institute for Community Medicine, University Medicine, 17475 Greifswald, Germany.
Institute for Nursing Science and Interprofessional Learning, University Medicine, 17475 Greifswald, Germany.
Int J Environ Res Public Health. 2023 Jan 26;20(3):2231. doi: 10.3390/ijerph20032231.
In rural areas, healthcare providers, patients and relatives have to cover long distances. For specialised ambulatory palliative care (SAPV), a supply radius of max. 30 km is recommended. The aim of this study was to analyse whether there are regional disparities in the supply of SAPV and whether it is associated with the distance between the SAPV team's site and the patient's location. Therefore, anonymised data of the Association of Statutory Health Insurance Physicians of the Federal State of Mecklenburg-Western Pomerania (M-V) were retrospectively analysed for the period of 2014-2017. Identification as a palliative patient was based on palliative-specific items from the ambulatory reimbursement catalogue. In total, 6940 SAPV patients were identified; thereof, 48.9% female. The mean age was 73.3 years. For 28.3% of the identified SAPV patients ( = 1961), the SAPV teams had a travel distance of >30 km. With increasing distance, the average number of treatment days per patient increased. It was found that there are regional disparities in the provision of SAPV services in M-V and that local structures have an important impact on regional supply patterns. The distance between the SAPV team's site and the patient's location is not the only determining factor; other causes must be considered.
在农村地区，医疗服务提供者、患者和家属不得不长途跋涉。对于专门的门诊姑息治疗（SAPV），建议供应半径最大为 30 公里。本研究的目的是分析 SAPV 的供应是否存在地区差异，以及它是否与 SAPV 团队所在地与患者所在地之间的距离有关。因此，对梅克伦堡-前波美拉尼亚州（M-V）法定健康保险公司医师协会（M-V）2014-2017 年期间的匿名数据进行了回顾性分析。姑息治疗患者的识别是基于门诊报销目录中的姑息治疗特定项目。共确定了 6940 名 SAPV 患者；其中，48.9%为女性。平均年龄为 73.3 岁。对于确定的 SAPV 患者中的 28.3%（=1961），SAPV 团队的旅行距离>30 公里。随着距离的增加，每位患者的治疗天数平均增加。研究发现，M-V 州在 SAPV 服务的提供方面存在地区差异，当地结构对区域供应模式有重要影响。SAPV 团队所在地与患者所在地之间的距离不是唯一的决定因素；必须考虑其他原因。
