Access to health care throughout the country

Abstract

The legal basis for describing the regional care situation is based on the adjusted supply rate of the 'demand planning guideline'. However, it provides only limited information about the accessibility of medical care which is crucial for the reality of patients' lives. The aim of this review is to present geographic approaches that spatially measure access to dermatological care in its physical and digital dimension. Here, on the one hand, the classical geographic parameter 'accessibility' is addressed, and on the other hand, data from the Federal Ministry of Transport and Digital Infrastructure (BMVI) on broadband coverage are presented as access parameters of teledermatological applications. In addition to the methodological approach, limitations and potentials in the interpretation of the results, minimum standards are also considered. The access parameters presented here make it possible to investigate spatial disparities and to present them clearly via cartographic representations. While the example of accessibility with a car shows almost area-wide access to the nearest dermatology practice (≤ 30 min), investigations on public transport accessibility reveal rather heterogeneous accessibility. Particularly in the identification of 'dual care gaps', sub-areas with poor physical and digital accessibility, these approaches could support and advance the application of alternative care models. However, the approaches presented here focus on potential accessibility. Further dimensions on actual physician utilisation or availability-also with regard to minimum standards-should be the subject of future research.