On the future development of ambulatory healthcare

鉴于2020年的大流行，社会比以往任何时候都更加强调医疗保健的重要性和到位的规定。医院和医生短缺，缺少初级保健医生-特别是在农村-大都市地区医疗顾问过剩，旅行限制和漫长的等待期，沿着医务人员的总体短缺;所有这些问题近年来都在新闻稿的头条中讨论。这表明规划和持续维持保健服务不是一项简单的任务。由于这些情况，需要进一步评估地区差异，沿着对德国门诊医疗服务提供及其未来发展的前瞻性研究，因此确定了本子项目研究。要取得成功，利用和增强的小面积微观仿真结构开发的第一阶段，本项目（MicroSim）是主要的。除了试点试验的日期外，对相关供应情况的预测和规划还可以进行微观模拟，以考虑微观层面的机制;认识到人口中社会结构部分之间的区别，以及对供应情况现状及其未来发展的非常小的地区分析。这样，医疗保健的两个方面-一个方面的医疗服务需求和具有不同工作安排的潜在医疗专家的数量-可以分开处理，并纳入模拟。需求现场受益于项目第一阶段（FOR 2559）中人口建模构建的现有结构，该结构将通过各种自己的研究（通常是区域化的研究）进行增强。这些研究显示了社会结构分化的疾病患病率和对医疗门诊绩效利用的行为。关于供应方的模型，研究小组提出了许多预备性研究报告。例如，医学生的职业选择、在职医生的情况以及对医疗服务中心的接受程度。供应（医生）和需求（患者）之间的比例可以根据现状以及随着时间的推移的发展进行进一步检查和评估。

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.