Morbidity related spatial accessibility of hospital-based internal medicine and surgery services in Germany.

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Worldwide, but also in Germany, there are considerable differences in terms of access to medical care. At the same time, needs-based and equal provision of care must be guaranteed for patients in Germany. Regarding equal access to health care, spatial accessibility plays a significant role as a spatial dimension of access. However, the current measurement of spatial accessibility in the hospital sector in Germany relies on simplifed methods with known limitations. This calls the validity of the current hospital planning in Germany into question.Therefore, this national cross-sectional epidemiological study will investigate the morbidity-related spatial accessibility of hospital based services in Germany using a sophisticated method to analyse spatial accessibility (“ integrated catchment area method”). Furthermore, the relationship of regional accessibility variations and the degree of urbanization as well as the degree of regional deprivation will be examined. In addition, the modelled demand of hospital based services within the analysis will be compared with the actual use of these services.The results can be used to reveal allocation problems with high precision and accuracy, and identify ways to improve the allocation process. Thus, the present study can be used as a scientific basis for hospital planning in Germany and help to ensure an equal and needs-based access to hospital services in Germany.