[Measures to ensure outpatient care in rural and structurally weak regions-a narrative review].

Abstract

Various public health measures are being implemented to ensure healthcare provision in rural and structurally vulnerable regions. However, the actual effect of these measures has not yet been fully clarified. This narrative review aims to identify relevant measures and compile existing evaluation results on their effectiveness.As part of a literature and document analysis, Google Scholar was used to search specific websites and databases of self-governing bodies in the healthcare sector (e.g. associations of statutory health insurance physicians and ministries) as well as relevant German journals. The results reveal a variety of conceptual approaches and practical measures designed to ensure healthcare provision. These are implemented as individual measures (e.g. "Rollende Arztpraxis") or complex bundles of measures (e.g. "Digitales Dorf"). Measures to improve the context, such as promoting the establishment of practices through the provision of affordable building land, and new organisational structures, such as doctor networks, are frequently employed, but their impact is often limited. Due to their relatively simple implementation, telemedicine measures are particularly important and are predominantly rated as having a positive effect.In principle, the evaluation of measures should be intensified further, with greater attention being paid to the methods and criteria used to evaluate their effectiveness. An accompanying evaluation should also ensure that successfully evaluated measures are not discontinued at the end of the project, but transferred to standard care if they are effective. Due to regional and local conditions, region-specific solutions should also be sought to optimise care.