ArticleBMC family practice2017
Which strategies might improve local primary healthcare in Germany? An explorative study from a local government point of view.
Article in BMC family practice, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 42 citations in OpenAlex.
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- Addressing Medical Deserts in Europe: Lessons From a Comparative Analysis.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Forgone and delayed care in Germany- inequalities and perceived health risk of unmet need.International journal for equity in health · 2025Article
- The legacy of the COVID-19 pandemic for the healthcare environment: the establishment of long COVID/ Post-COVID-19 condition follow-up outpatient clinics in Germany.BMC health services research · 2025Observational
- Professional and academic pre-qualifications, career preferences and aspirations in working as a rural doctor.Frontiers in medicine · 2025Article
- Telehealth for primary healthcare delivery in rural and remote contexts in high-income countries-a scoping review.mHealth · 2025Review
- Improving the introduction of telemedicine in pre-hospital emergency medicine: understanding users and how acceptability, usability and effectiveness influence this process.BMC emergency medicine · 2024Article
- [How to Motivate Medical Students to Practice in Rural Areas].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2024Article
- Experiences with the quality of telemedical care in an offshore setting - a qualitative study.BMC health services research · 2023Article
- Mobile primary healthcare for post-COVID patients in rural areas: a proof-of-concept study.Infection · 2023Observational
- [Effects of the Covid-19 Pandemic on Online Use of Video Consultation by General Practitioners in Germany - a Secondary Data Analysis of German Health Insurance Data].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2023Article
- Factors promoting willingness to practice medicine in rural regions and awareness of rural regions in the university's catchment area - cross-sectional survey among medical students in central Germany.GMS journal for medical education · 2023Article
- Characteristics of Medical Deserts and Approaches to Mitigate Their Health Workforce Issues: A Scoping Review of Empirical Studies in Western Countries.International journal of health policy and management · 2023Article
- Evaluation of Synchronous and Asynchronous Telemedical Applications in Primary Care in Rural Regions of Northern Germany-Results and Lessons Learned from a Pilot Study.International journal of environmental research and public health · 2022Article
- Development of a performance measurement system for general practitioners' office in China's primary healthcare.BMC health services research · 2022Article
- Healthcare professionals' perceptions of impacts of the Covid-19-pandemic on outpatient care in rural areas: a qualitative study.BMC health services research · 2021Article
- Facilitators and barriers for the implementation of telemedicine from a local government point of view - a cross-sectional survey in Germany.BMC health services research · 2021Article
- Mobile diagnostics and consultation for the prevention of the metabolic syndrome and its secondary diseases in Brandenburg-study protocol of a regional prospective cohort study: the Mobile Brandenburg Cohort.Pilot and feasibility studies · 2021Article
- Risk Factor Management in Non-Metropolitan Patients with Coronary and Peripheral Artery Disease - A Protocol of a Prospective, Multi-Center, Quality Improvement Strategy.Vascular health and risk management · 2021Article
- The contribution of service density and proximity to geographical inequalities in health care utilisation in Indonesia: A nation-wide multilevel analysis.Journal of global health · 2020Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFacing rising inequities and poorer accessibility of physicians in rural areas, new healthcare delivery structures are being considered to support local healthcare in German communities. To better understand perspectives on and attitudes towards different supplementary models, we examined attitudes among local politicians in the German federal state of Lower Saxony towards the suitability of supplementary care models.
methodsAs part of a cross-sectional study, we surveyed local politicians in Lower Saxony at the local authority and district levels (n = 449) by mail questionnaire. We asked for an assessment of four potential supplementary healthcare models at the local level: the use of trained medical assistants, patients' buses, mobile physicians' offices, and telemedicine.
resultsThe response rate was 71.0% for mayors (n = 292) and 81.6% (n = 31) for county administrators. In summary, 72.4% of respondents supported the use of trained medical assistants, 48.9% voted for patients' buses, 22.0% for mobile physicians' offices, and 13.9% for telemedicine. Except for telemedicine, the politicians' approval of the supplementary models in rural areas was higher than in urban areas. The assessment regarding the suitability of each model was not significantly connected with indicators of a positively or negatively assessed local healthcare situation. The analyses showed that the use of trained medical assistants was associated with the positive effects of division of labor and potential to relieve physicians. In contrast, there was skepticism about technical support via telemedicine, mostly due to concerns about its unsuitability for elderly people and the potential lower quality of healthcare delivery.
conclusionLocal politicians widely accept the use of trained medical assistants, whereas the applicability of technical solutions such as telemedicine is perceived with skepticism. Therefore, the knowledge gap between evidence for and prejudices against telemedicine needs to be addressed more effectively. Reasons for the assessments of the presented models are more likely traceable to personal views than to assessments of the actual estimated local primary care situation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.