Berufliche und private Standortfaktoren für die Niederlassung von Hausärzten in ländlichen Räumen

Abstract

The safeguarding of primary health care in rural regions is broadly discussed in science, politics and practice. Thereby the knowledge about current location factors is insufficient, because existing studies focus on professional factors or on locational imaginations of future doctors instead of analysing effective locational decisions. Thus, this study asks which professional and private location factors influence the settling decisions of general practitioners in rural regions. Therefore two regional case studies are conducted with overall 21 interviews with regional experts and newly settled doctors, working out crucial location factors. Building on that, the influence of chosen location factors for regional unequal practitioner concentrations as well as for the development of practitioner numbers are nationwide quantified by multiple regression models. The results show, that professional aspects, like economic security, close patient contacts and organisational freedom, as well as biographical relations are especially decisive criteria for the doctors’ location decisions. Furthermore, family-friendly everyday environments are very important for many of them. Other soft location factors as high standard cultural and leisure facilities are negligible. Furthermore, there is a relationship between inpatient and outpatient care. Many general practitioners worked in a regional hospital, before they switched to the ambulant sector, due to better working conditions and an easier compatibility with family life. The results point to a change of location factors, whereby further needs for research and concrete policy recommendations arise.

Keywords

• Primary health care
• Shortage of doctors
• Decisions about locations
• Basic service provision
• Demographic change