Artikel
Assessing Accessibility: A Comprehensive Multimodal Study of Primary Care Accessibility Across Germany
Suche in Medline nach
Autoren
-
Benjamin Bangert
- Centre for Artificial Intelligence in Public Health Research, Robert Koch Institute, Berlin, Germany; Lusatian Centre for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
-
Martin Stabler
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany; Lusatian Centre for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
-
Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany; Lusatian Centre for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
-
Tim Herath
- Centre for Artificial Intelligence in Public Health Research, Robert Koch Institute, Berlin, Germany; Lusatian Centre for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
-
Lea Martens
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany; Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany; Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany; Lusatian Centre for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
-
Henriette Hecht
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany; Lusatian Centre for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
-
Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany; Lusatian Centre for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
-
Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany; Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany; Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany; Lusatian Centre for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
-
Katharina Ladewig
- Centre for Artificial Intelligence in Public Health Research, Robert Koch Institute, Berlin, Germany; Lusatian Centre for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
-
Christopher Irrgang
- Centre for Artificial Intelligence in Public Health Research, Robert Koch Institute, Berlin, Germany; Lusatian Centre for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| Veröffentlicht: | 6. September 2024 |
|---|
Gliederung
Text
Background: In the context of healthcare, primary care physicians represent the initial point of contact with the healthcare system [1]. In Germany, the use of motorised private transport for day-to-day travel remains the dominant mode of transport [2]. However, a range of factors, including environmental concerns, socio-economic challenges, and health-related issues, may act as deterrents for citizens from utilising these vehicles. This study aims to assess the geographical accessibility of primary care physicians by using alternative transportation modes, such as public transport or walking, to identify regions in Germany with limited accessibility to primary care physicians in order to ensure the equitable distribution of healthcare.
Methods: A state-of-the-art routing engine [3] based on the RAPTOR algorithm is employed to calculate travel times from census grid cells to primary care physicians. The routing process incorporates multimodal transportation, including walking, biking, public transport and motorised private transport. Various metrics like the cost to closest facility, Hansen’s accessibility measure, and the balanced floating catchment area [4], are utilised to analyse and compare the accessibility and distribution of primary care physicians when using different transportation modes. The data on travel times and frequencies are collected, analysed and visualised using R and Python implementations.
Results: A preliminary analysis revealed disparities in how different modes of transport allow individuals to access primary care physicians within a reasonable travel time. It is notable that while public transport has the potential to replace motorised private transport in urban areas, the analysis indicates that it falls short in rural regions and smaller cities. In these key regions the coverage of services and the transport network do not meet the primary care demand as well as they do in urban areas. The preliminary study indicated that regions with higher socio-economic deprivation have less efficient access to primary care physicians by alternative transportation modes. The findings are visualised through heat maps, which highlight key regions where alternatives to motorised private transport do not adequately meet the needs of the population.
Conclusion: The study suggests that in Germany, public transport may not yet be sufficient to ensure accessibility to primary care physicians for those without access to motorised private transport, particularly in smaller cities and rural regions. This is probably of particular relevance for the elderly and parents with children likely to have higher primary care needs. Enhanced public transport options could be pivotal in addressing these gaps in equitable healthcare access, especially for rural regions. Although mobile health services suffer from inherent limitations, such as gaps in adaptation for different socio-economic groups [5], they could be employed to address existing scarcities in the transportation networks and ensure that all citizens have the opportunity to access essential healthcare services in an efficient manner.
The authors declare that they have no competing interests.
The authors declare that an ethics committee vote is not required.
References
- 1.
- World Health Organization; UNICEF. Operational framework for primary health care: transforming vision into action. Geneva: World Health Organization, UNICEF; 2020 [cited 2024 Apr 27]. p. 13. Available from: https://www.who.int/publications/i/item/9789240017832
- 2.
- European Commission: Directorate-General for Mobility and Transport. EU transport in figures: Statistical pocketbook 2023. Luxembourg: Publications Office of the European Union; 2023. p. 49. DOI: 10.2832/319371
- 3.
- Higgins C, Palm M, DeJohn A, Xi L, Vaughan J, Farber S, et al. Calculating place-based transit accessibility: Methods, tools and algorithmic dependence. JTLU. 2022; 15(1):95–116. DOI: 10.5198/jtlu.2022.2012
- 4.
- Paez A, Higgins C, Vivona SF. Demand and Level of Service Inflation in Floating Catchment Area (FCA) Methods. PLOS ONE. 2019;14(6):e0218773. DOI: 10.1371/journal.pone.0218773
- 5.
- Kumar D, Hemmige V, Kallen MA, Giordano TP, Arya M. Mobile Phones May Not Bridge the Digital Divide: A Look at Mobile Phone Literacy in an Underserved Patient Population. Cureus. 2019;11(2):e4104. DOI: 10.7759/cureus.4104
