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

在世界范围内，但在德国，在获得医疗保健方面也存在相当大的差异。同时，必须保证在德国为患者提供基于需求的平等护理。关于平等获得保健的问题，空间可获得性作为可获得性的一个空间层面发挥着重要作用。然而，目前德国医院部门对空间可达性的测量依赖于已知局限性的简化方法。因此，这项全国性的横断面流行病学研究将使用复杂的空间可达性分析方法(“综合集水区法”)来调查德国基于医院的服务的发病率相关的空间可达性。此外，还将研究区域可达性差异与城市化程度以及区域剥夺程度的关系。此外，分析范围内的医院基础服务的建模需求将与这些服务的实际使用情况进行比较，结果可以高精度和准确性地揭示分配问题，并找出改进分配流程的方法。因此，本研究可以作为德国医院规划的科学基础，并有助于确保德国平等和根据需要获得医院服务。

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.