PhD Scientific Days 2023

Health Sciences - Posters Q

Does the place of residence influence access to psychotherapy among children and adolescents in Cologne?

Text of the abstract

Introduction
Healthcare services in the outpatient sector in Germany are provided on the basis of a needs analysis (§§ 99 ff . SGB V). The permitted ratio of doctors relative to the population in a district is based on the actual number of physicians in the old (West German) federal states as of 31 December 1990 (§ 5 BedarfsPlRL) without empirical validation of the distribution (Ozegowski and Sundmacher 2012). The resulting care situation was studied in particular in comparison with regional differences, showing an unequal distribution especially in rural areas (Kistemann and Schröer 2007; Strumann et al. 2020). However, a point of criticism of the demand planning is the uneven distribution within planning areas, some of which cover large areas (Fülöp, Kopetsch, and Schöpe 2007). The city of Cologne is the third largest city in Germany and thus potentially affected by the unequal distribution. In particular, supply shortages for psychotherapy have been discussed in Germany in recent years. For children and adolescents in particular, long journeys from their place of residence to the place of healthcare provision can be a barrier to healthcare access.
Aims
The aim of this study is to analyse whether geographical disparities exist in the child and adolescent psychiatry and psychotherapy within the city of Cologne.
Method
The study is based on (1) a geographical-statistical analysis of the use of child and adolescent psychiatry and psychotherapy care in the city of Cologne (based on claims data of the statutory health insurance system) and (2) on geographical mapping of the number of practices with the permission to reimburse respective services under the statutory health insurance in the Cologne urban area.
Results
For the city of Cologne, there is a concentration of providers in the city centre and on the left side of the Rhine. Socially weaker areas of the city have lower rates of providers. The utilisation of care by children and young people in 2021 is currently being evaluated and will be presented at the conference.
Conclusion
Whether access due to long distances to providers within the city of Cologne leads to an unequal distribution of utilisation and opportunities for utilisation is currently being evaluated. The concentration of providers in wealthier parts of the city suggests that socially weaker children and young people are disadvantaged.
Funding
Self-Funded

References
Fülöp, G., T. Kopetsch, and P. Schöpe. 2007. “Bedarfsgerechte Versorgungsplanung.” Gesundheits- und Sozialpolitik (7-8): 57–63.
Kistemann, T., and M-A Schröer. 2007. “Kleinräumige kassenärztliche Versorgung und subjektives Standortwahlverhalten von Vertragsärzten in einem überversorgten Planungsgebiet.” [Small-scale care by SHI physicians and their subjective choice of location within an oversupplied planning area]. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) 69 (11): 593–600. doi:10.1055/s-2007-991174.
Ozegowski, S., and L. Sundmacher. 2012. “Wie "bedarfsgerecht" ist die Bedarfsplanung? Eine Analyse der regionalen Verteilung der vertragsärztlichen Versorgung.” [Is the needs-based planning mechanism effectively needs-based? An analysis of the regional distribution of outpatient care providers]. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) 74 (10): 618–26. doi:10.1055/s-0032-1321748.
Strumann, Christoph, Timo Emcke, Kristina Flägel, and Jost Steinhäuser. 2020. “Regionale Unterschiede zwischen Fachärztinnen und Fachärzten für Allgemeinmedizin und hausärztlich tätigen Internistinnen und Internisten in der hausärztlichen Versorgung.” [Regional differences between general practitioners and general internal medicine physicians in primary care]. Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen 150-152:88–95. doi:10.1016/j.zefq.2020.01.005.