[Population density, age distribution and urbanisation as factors influencing the frequency of home visits--an analysis for Mecklenburg-West Pomerania].
BACKGROUND
This study examines and compares the frequency of home visits by general practitioners in regions with a lower population density and regions with a higher population density. The discussion centres on the hypothesis whether the number of home visits in rural and remote areas with a low population density is, in fact, higher than in urbanised areas with a higher population density. The average age of the population has been considered in both cases.


METHODS
The communities of Mecklenburg West-Pomerania were aggregated into postal code regions. The analysis is based on these postal code regions. The average frequency of home visits per 100 inhabitants/km2 has been calculated via a bivariate, linear regression model with the population density and the average age for the postal code region as independent variables. The results are based on billing data of the year 2006 as provided by the Association of Statutory Health Insurance Physicians of Mecklenburg-Western Pomerania. In a second step a variable which clustered the postal codes of urbanised areas was added to a multivariate model.


RESULTS
The hypothesis of a negative correlation between the frequency of home visits and the population density of the areas examined cannot be confirmed for Mecklenburg-Western Pomerania. Following the dichotomisation of the postal code regions into sparsely and densely populated areas, only the very sparsely populated postal code regions (less than 100 inhabitants/km2) show a tendency towards a higher frequency of home visits. Overall, the frequency of home visits in sparsely populated postal code regions is 28.9% higher than in the densely populated postal code regions (more than 100 inhabitants/km2), although the number of general practitioners is approximately the same in both groups. In part this association seems to be confirmed by a positive correlation between the average age in the individual postal code regions and the number of home visits carried out in the area. As calculated on the basis of the data at hand, only the very sparsely populated areas with a still gradually decreasing population show a tendency towards a higher frequency of home visits.


CONCLUSIONS
According to the data of 2006, the number of home visits remains high in sparsely populated areas. It may increase in the near future as the number of general practitioners in these areas will gradually decrease while the number of immobile and older inhabitants will increase.
Heymann
R
R
Institut für Community Medicine, Abteilung Versorgungsepidemiologie und Community Health, Ernst-Moritz-Arndt Universität Greifswald. romy.heymann@uni-greifswald.de
Weitmann
K
K
Weiss
S
S
Thierfelder
D
D
Flessa
S
S
Hoffmann
W
W
D017677:Age Distribution; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011156:Population Density; D014505:Urban Population / Q000706:statistics & numerical data*