title: Methods of analyzing regional dermatological care as exemplified by the city of Hamburg.
abstract: BACKGROUND
  The rural-urban divide is often linked to regional inequalities in healthcare. However, studies have also shown regional healthcare disparities within urban areas. To evaluate these studies, further parameters such as accessibility must be added to the standard criteria. The objective of this study was to present methodic tools for evaluating dermatological healthcare provision in Hamburg, primarily focusing on accessibility.
  
  
  METHODS
  Analyzing data from 97 districts, the geographical distribution of 101 dermatologists and the physician-patient ratio were determined. In a second step, network analysis regarding accessibility was performed.
  
  
  RESULTS
  There are regional inequalities in Hamburg with respect to dermatological care. Depending on the district, the physician-patient ratio ranges from 44.9 % (undersupply) to > 500 % (oversupply). Similar differences exist regarding accessibility. Although 94.5 % of the population of Hamburg is able to reach the nearest dermatologist within ten minutes (by car), it may take more than 30 minutes depending on district and mode of transportation.
  
  
  CONCLUSIONS
  Analysis of the physician-patient ratio reveals differences regarding dermatological care in Hamburg. However, results of the network analysis show that these differences do not significantly affect access to dermatological care. Therefore, network analysis should be used as an additional tool to evaluate regional healthcare provision.
authors.affiliation: Institute for Healthcare Research in Dermatology and the Care Professions (IVDP), University Hospital Hamburg-Eppendorf, Hamburg.
authors.forename: Jobst
authors.initials: J
authors.lastname: Augustin
authors.affiliation: Geographical Institute of the University of Göttingen, Dept. of Cartography, GIS and Remote Sensing, Göttingen.
authors.forename: Stefan
authors.initials: S
authors.lastname: Erasmi
authors.affiliation: Dermatology Group Practice am Tibarg and Institute for Strategic Analysis in Dermatology (IStAD), Hamburg.
authors.forename: Michael
authors.initials: M
authors.lastname: Reusch
authors.affiliation: Institute for Healthcare Research in Dermatology and the Care Professions (IVDP), University Hospital Hamburg-Eppendorf, Hamburg.
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D003880:Dermatology / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000600:supply & distribution*; D012041:Regional Medical Programs / Q000706:statistics & numerical data*; D014195:Travel / Q000706:statistics & numerical data*; D014505:Urban Population; D014600:Utilization Review / Q000379:methods; D055815:Young Adult