AbstractGeneral practitioner (GP) care in Germany is characterized by a disparate distribution of GPs, explain Stefan Greß und Klaus Stegmüller. There is considerable oversupply in many urban areas while there is undersupply in many rural regions. Centralized planning of GP capacities so far has not been able to ameliorate this unequal distribution. What is more, several health policy reforms have not been able to make capacity planning more effective. The authors suggest a framework for more effective allocation of GP resources by decentralizing capacity planning to the level of local municipalities.Juergen Zerth refers to the ongoing debate on the adequate distribution of physicians that are obliged to guarantee the overall access to health care in Germany. Especially in rural regions, the number of general practioners will decline in the next years, he states. From a health economics point of view it has to be discussed which role physicians have to play within different forms of organizing care and cure. In the paper, a standardized utility function that depicts physicians’ interest helps to figure out the range in which physicians have an interest to choose an engagement in rural environments contingent of aspects of risk sharing between caretaker und cost payers. In consequence, patient driven care models will enforce new organizational and institutional arrangements of division of labour between medical practitioners as well as new needs to reorganize regional medical facilities.Hans-Joachim Helming presents a possible solution approach to ensure the ambulatory care in economically underdeveloped, rural areas. Some regions of Brandenburg in in the northeast of Germany face a shortage of medical care that is primarily caused by the change of generations, the lack of young people and the little existing infrastructure. In these parts of Brandenburg one also sees the consequences of the demographic change: the population is older, less mobile, and the proportion of multi-morbid patients comparatively increased. In addition, the practicing physicians tend to be older and young doctors are becoming less willing to settle in their own surgery. To cope with these challenges the Regional Associations of Statutory Health Insurance Physicians in Brandenburg (Kassenärztliche Vereinigung Brandenburg) invented the KV RegioMed Program. KV RegioMed is a modular concept with regionally tailored solutions that can be combined as needed. The concept meshes medical and non-medical capacities. Competencies and resources can be bundled by outpatient and inpatient areas and intertwined across different sectors.
Respectful Adolescent Care: A Right of Every Adolescent
