Regional differences in the patient population of general practices in northern Germany: results of a mixed-methods study

Author:

Hansen HeikeORCID,Schäfer IngmarORCID,Pohontsch Nadine JanisORCID,Kazek Agata,Hardt Hanna,Lühmann Dagmar,Scherer Martin

Abstract

ObjectivesThe aim of our study was to explore patient types in general practitioner (GP) practices and to quantify the regional differences of the frequencies of these patient types in northern Germany.Design and settingWe conducted a mixed-methods study based on focus groups and standardised interviews with GPs. All counties and independent cities within a radius of 120 km around Hamburg were assigned one of three regional categories (urban areas, environs, rural areas). The focus groups were analysed using qualitative content analysis. Relative frequencies of consultations by patient types and differences between the regions were calculated. Logistic regression analyses were used to identify differences among regions.ParticipantsNine focus groups with 65 GPs (67.7% male). From the 280 initially recruited GPs 211 (65.4% male) could be personally interviewed.ResultsFour themes with 27 patient types were derived from the focus groups: patients classified by morbidity, sociodemographic characteristics, special care needs and patient behaviour. Five patient characteristics were significantly more prevalent in urban areas than rural areas: patients with migration background and culturally different disease concepts (OR 1.23; 95% CI 1.06 to 1.42), privately insured patients (OR 1.17; 95% CI 1.05 to 1.31), educationally disadvantaged patients with low health literacy (OR 1.11; 95% CI 1.04 to 1.19), patients with psychiatric disorders (OR 1.07; 95% CI 1.02 to 1.12) and senior citizens living on their own without caregivers (OR 1.05; 95% CI 1.05 to 1.31). Three patient types were significantly less prevalent in urban areas: minors accompanied by their parents (OR 0.71; 95% CI 0.61 to 0.83), patients with poor therapy adherence (OR 0.87, 95% CI 0.80 to 0.95) and patients with dementia (OR 0.90; 95% CI 0.82 to 0.99).ConclusionsGPs could compensate the specific needs of their patients with medical training aligned with the requirements of their region. Urban GPs need skills treating patients with psychiatric, social and cultural problems, rural GPs regarding the care for children or noncompliant patients.Trial registration numberNCT02558322

Funder

Hamburg and Schleswig-Holstein Association of Statutory Health Insurance Physicians

Publisher

BMJ

Subject

General Medicine

Reference47 articles.

1. Albrecht M , Etgeton S , Ochmann RR . Faktencheck Gesundheit - Regionale Verteilung von Arztsitzen (Ärztedichte) - Haus-.Kinder-, Frauen- und Augenärzte. Available: https://www.bertelsmann-stiftung.de/fileadmin/files/BSt/Publikationen/GrauePublikationen/GP_Faktencheck_Gesundheit_Aerztedichte.pdf [Accessed 18 Mar 2016].

2. Understanding shortages of sufficient health care in rural areas;Weinhold;Health Policy,2014

3. Regional differences in reasons for consultation and general practitioners’ spectrum of services in northern Germany – results of a cross-sectional observational study;Schäfer;BMC Fam Pract,2020

4. Prozeduren, die in Der Allgemeinmedizin durchgeführt werden – eine Querschnittstudie;Steinhäuser;Gesundheitswesen,2017

5. A comparison of the workload of rural and urban primary care physicians in Germany: analysis of a questionnaire survey;Steinhaeuser;BMC Fam Pract,2011

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