TY - JOUR

T1 - Einflussfaktoren auf die Standortwahl von hausärztlichen Land- und Stadtärzten in Niedersachsen

AU - Schmidt, Katharina

AU - Marten, Ole

AU - Kühne, Christian

AU - Zeidler, Jan

AU - Frank, Martin

N1 - Publisher Copyright: © Georg Thieme Verlag KG, Stuttgart, New York. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background and aim The overall distribution and appropriate general practitioner (GP) supply is an increasing challenge. Therefore, the analysis of priorities and factors regarding the location of GPS' practice is of major importance for a need-based coordination of physician supply. In this study, priorities and factors regarding the location of GPS in Lower Saxony were analysed and evaluated. The aim of this study was to elicit the preferences of physicians in regard to location factors. The knowledge about these preferences could contribute to new distribution approaches of GP practices considering physicians' wishes. Methods The first part of the study, called the PrEf, aimed to identify and prioritize the influencing factors for the establishment of a GP's practice with the Analytic Hierarchy Process (AHP) method in personal interviews. In the next step, we conducted a cross sectional study in Lower Saxony, called QuESt. In the QuESt study, we analyzed the preferences regarding the location of the practice for GPS in rural areas compared to GPS in urban areas with logistic regression methods. Results The first part of the study (PrEf) consisted of 10 valid AHP interviews. The most important influential factor found in PrEf is the family's surroundings with a global weight of 32,4 % (SD = 19,4), followed by financial conditions (19,0 %, SD = 13,0) and work obligations (13,4 %, SD = 9,0). The results from QuESt (n = 197) showed that the importance of financial conditions differed between rural and urban GPS: The rural GPS evaluated financial conditions by 0.84 points more important (p ≤ 0,05). Conclusions The major influential factor for establishment of a practice is the family's surroundings that often do not correspond to the GPS' wishes. Financial conditions ranked second, which is also important for the GPS, especially for rural GPS. Politicians, the Associations of Statutory Health Insurance Physicians, and local authorities should focus on these aspects as regulating factors.

AB - Background and aim The overall distribution and appropriate general practitioner (GP) supply is an increasing challenge. Therefore, the analysis of priorities and factors regarding the location of GPS' practice is of major importance for a need-based coordination of physician supply. In this study, priorities and factors regarding the location of GPS in Lower Saxony were analysed and evaluated. The aim of this study was to elicit the preferences of physicians in regard to location factors. The knowledge about these preferences could contribute to new distribution approaches of GP practices considering physicians' wishes. Methods The first part of the study, called the PrEf, aimed to identify and prioritize the influencing factors for the establishment of a GP's practice with the Analytic Hierarchy Process (AHP) method in personal interviews. In the next step, we conducted a cross sectional study in Lower Saxony, called QuESt. In the QuESt study, we analyzed the preferences regarding the location of the practice for GPS in rural areas compared to GPS in urban areas with logistic regression methods. Results The first part of the study (PrEf) consisted of 10 valid AHP interviews. The most important influential factor found in PrEf is the family's surroundings with a global weight of 32,4 % (SD = 19,4), followed by financial conditions (19,0 %, SD = 13,0) and work obligations (13,4 %, SD = 9,0). The results from QuESt (n = 197) showed that the importance of financial conditions differed between rural and urban GPS: The rural GPS evaluated financial conditions by 0.84 points more important (p ≤ 0,05). Conclusions The major influential factor for establishment of a practice is the family's surroundings that often do not correspond to the GPS' wishes. Financial conditions ranked second, which is also important for the GPS, especially for rural GPS. Politicians, the Associations of Statutory Health Insurance Physicians, and local authorities should focus on these aspects as regulating factors.

KW - Analytic Hierarchy Process

KW - health service needs

KW - locational factors

KW - physician allocation

KW - Physician shortage

UR - http://www.scopus.com/inward/record.url?scp=85013920683&partnerID=8YFLogxK

U2 - 10.1055/s-0043-103092

DO - 10.1055/s-0043-103092

M3 - Artikel

AN - SCOPUS:85013920683

VL - 22

SP - 280

EP - 289

JO - Gesundheitsokonomie und Qualitatsmanagement

JF - Gesundheitsokonomie und Qualitatsmanagement

SN - 1432-2625

IS - 6

ER -