On the future development of ambulatory healthcare

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Society, now more than ever given the 2020 pandemic, has highlighted the importance of healthcare and the provisions in place. A shortage of hospitals and doctors, missing primary care physicians– especially in the countryside– a surplus of medical consultants in metropolitan areas, travel restrictions and long waiting periods, along with an overall shortage of medical staff; all these issues have been discussed in recent years within headline press releases. This indicates the planning and continued maintenance of health care provisions are not simple tasks. Due to these circumstances, further evaluation of regional differences is required, along with prospective studies on the out-patient provision of medical care in Germany and its prospective developments, hence the setting of this subprojects research. To succeed, the utilization and enhancement of the small area microsimulation structure developed in Phase I of this Project (MicroSim) is primary. In addition to the date piloted experiments, the prediction and planning of the relevant supply situation allows microsimulations to consider the mechanisms on the microlevel; recognizing distinctions between socio-structural sections of the population as well as very small area analysis with regard to the status quo of the supply situation and its prospective developments. This way both aspects of health care– the demand for medical services on one and the number of potential medical specialists with different working arrangements– could be treated separately and be integrated into the simulation. The demand site benefits from the pre-existing structure of the demographic modelling build in Phase I of the Project (FOR 2559), which will be augmented by various own, and often regionalized, studies. These studies display socio-structural differentiated disease prevalences and behaviour towards the utilization of the medical out-patient performances. As for the modelling of the supply side, there are numerous preparatory studies presented by the research group. For instance, career choices of medical students, the situation of employed physicians and the acceptance of medical service centres. The ratio between supply (physicians) and demand (patients) could be further examined and evaluated in terms of the status quo as well as the development over time.