Zwischen Nähe und Not: Determinanten längerer Wege zur Notaufnahme – Eine Subauswertung der Inanspruchnahmebefragung in bayerischen Notaufnahmen

Abstract

Introduction

Emergency care in Germany is under strain due to increasing patient numbers, limited resources, and a high proportion of non-urgent consultations. Against the backdrop of the hospital reform, which stipulates that patients should be able to reach a basic care hospital within 30 minutes (min), this sub-analysis examines patients who deliberately accept longer travel times (>30 min). The aim was to identify predictors and motives of this group.

Methods

In the Bavarian Emergency Department (ED) Utilisation Survey (n = 7,527), 1,128 patients with travel times exceeding 30 min were analysed. Travel times were calculated using postal code coordinates. Descriptive analyses and multivariate logistic regression were performed.

Results

Fifteen percent of respondents reported travel times of more than 30 min (mean: 44 min); 79.5% accepted travel times of at least 10 minutes more than to the nearest emergency department. High perceived urgency (31% very urgent; 18% emergency), severe pain (51% of respondents with pain), and prior attempts to contact outpatient physicians (49%) were frequently reported. Contact attempts were successful in 87% of cases for general practitioners and in 82% for specialists. Gynaecological, ophthalmological, and otorhinolaryngological complaints showed the strongest associations with longer travel distances.

Discussion and conclusion

Longer travel times may not only reflect a perceived need for greater expertise and safety but also indicate actual gaps in service provision, particularly in specialties that are only available at larger emergency departments. Policy and management measures should therefore consider geographic accessibility along with the regional availability of specialized services, awareness of consultation services, and transparent communication about hospital service profiles.