Regional Healthcare Service Provision By Gynecologists and General Practitioners for Women 49 Years of Age and Older in Germany

In Germany, the mandatory statutory health insurance supports universal health care coverage. However, due to demographic changes and regional differences we are facing inequalities in access and provision of healthcare services. Therefore, the current needs-related planning of physicians for ambulatory care requires revision.

In 2016 with the goal of contributing to the improvement of healthcare service provision, The Joint Federal Committee established the Innovationsfonds. Our project, funded by the Innovationsfonds, analyses ambulatory gynecological healthcare service provision for middle-aged and older women.

Initial evidence shows reduced access to gynecologists (Gyn) for women over 49 years living in rural areas and with lower socioeconomical status. Up to now, health policy disregards aging population for adjusting the needs-related planning of Gyn.

The aim of this project is to explore current ambulatory healthcare services for women over 49 years by Gyn and general practitioners (GPs) and to identify innovative interdisciplinary solutions to face the imminent undersupply i.e. task-shifting. For this purpose, we apply a mixed method approach including a randomized survey of GPs and Gyn from three northeast states (about 1.000 GPs and 500 Gyn), semi-structured telephone based interviews with women over 49 years of age from the same regions, a systematic literature review, and secondary data analysis. Based on our results we will develop a new concept to improve the ambulatory gynecological health care provision. To do so, we choose a participatory approach using focus groups including major stakeholders.

To conclude, sociological theory and methods are important in this healthcare research since we are dealing with societal challenges such as social inequality. In this case, our assignment is to inform health policy regarding possible improvements in healthcare services and practices. Our ultimate goal is to contribute to the improvement of women’s quality of life contemplating physicians and patients’ needs.