Zi publishes study on the future stress on practicing doctors
10.08.2023 15:31
Increasing use of statutory medical services is expected, particularly in metropolitan areas. Particular focus: internal medicine, urology and ophthalmology. Also psychotherapy with increasing stress projection.
Patients will probably continue to make heavy use of statutory medical and psychotherapeutic care nationwide in the next few years. According to current forecasts, the population in Germany is no longer decreasing overall due to increasing migration. A decline in population in rural regions is countered by an increasing densification of urban areas. This means that the demand on primary care and specialist medical care will increase even more in urban agglomerations than in less populated areas. The increasing aging of the population in Germany is contributing to the fact that specific specialist groups such as internal medicine, urology and ophthalmology will be in increasing demand in the coming years. Demand for specialist internists and urologists could increase by up to ten percent nationwide by 2035. In ophthalmology and ear, nose and throat doctors, this stress index could increase by up to eight percent. A slight increase in population is also projected for younger insured persons up to the age of 14. A slight increase in the population is also projected, so that an increasing demand on pediatricians and adolescent doctors can be expected (+ 3 percent).
Significant increase in the field of psychotherapy
The projection of the supply requirement for the area of psychotherapy is even clearer: based on the population forecast and taking into account the development of utilization in recent years, there is a projected increase in demand of 21 percent for psychotherapists and 27 percent for child and adolescent psychiatrists by 2035 :Inside. According to estimates, the workload on gynecologists will be around five percent lower on average in 2035 than in the base year. A slight increase of two percent is expected in the future workload on family doctors. The spatial analysis shows a particularly high increase in stress across the majority of the specialist groups in the southern and some western regions of Germany and partly in the greater Berlin-Brandenburg area. A decreasing use of many specialist groups is projected, particularly for rural areas in eastern Germany. These are the central results of a current demand projection for the future demands on contract doctors and psychotherapists up to 2035, which the Central Institute for Statutory Health Insurance (Zi) published today in the Care Atlas.
Particular challenges in regions with declining populations
“Very different demographic developments are forecast within Germany. While the population in metropolitan areas is growing and remains almost constant in the western countries, a gradual decline is expected in the eastern countries. In regions with declining populations, particular challenges arise for the organization of care. This concerns the replacement of necessary practice locations and the organization of care in increasingly larger practice catchment areas. This requires new forms of organization for the practices and appropriate financial support,” said the Zi board chairman
Dr. Dominik von Stillfried.
Significant increase in the number of cases for the treatment of older people
“We expect a significant increase in the number of cases among certain specialist groups who are mainly involved in the treatment of older people, especially among specialist internists. This reflects shifts from inpatient hospital treatment, more specialization but also more specialist medical treatment and interdisciplinary cooperation, which are leading to increasing patient and case numbers. We also have to keep in mind that medical progress is making more and more outpatient treatments possible and less and less hospital treatment necessary. That's why we have to rethink: Up to now we have viewed metropolitan areas as oversupplied with medical care. The fact is that we must expect a particular increase in supply requirements there,” von Stillfried continued.
On the methodology of the presented relative stress index (rBIX):
Based on statutory health insurance billing data from the last pre-pandemic year of 2019 and a population forecast, utilization will be updated to 2035. As a new element, the development of utilization from 2011 to 2019 is also determined, which is also included in the projection. The result is the relative stress index (rBIX), which is calculated for different specialist groups and regionally. It indicates by what percentage the use of statutory medical services in 2035 is expected to differ from that in the base year 2019.
Hering R, Schulz M, Czihal T. Future relative stress on contract doctors - a projection by specialist group until 2035. Central Institute for Statutory Health Insurance in Germany (Zi). Supply Atlas Report No. 23/07. Berlin 2023. > https://doi.org/10.20364/VA-23.07