title: The demographic impact on the demand for emergency medical services in the urban and rural regions of Bavaria, 2012-2032.
abstract: OBJECTIVE
  In most regions of the world, the proportion of older people in the population has increased during the last decades. As this entails major consequences for the healthcare sector, this study isolates and quantifies the impact of an aging population on the demand for emergency medical services in different types of regions in Bavaria between 2012 and 2032.
  
  
  METHODS
  Dispatch data of the emergency medical services were combined with population data and forecasts. Age-specific rates of emergency ambulance dispatches were calculated and used for a 20-year-projection for all 71 rural and 25 urban districts of Bavaria. Tests for differences between these two types of regions were applied.
  
  
  RESULTS
  Per capita rates of emergency ambulance dispatches in urban regions tend to be higher and there is an urban-rural distinction in the rates of specific age groups. The projection predicted an overall increase in emergency ambulance dispatches by 21 % in Bavaria within 20 years, solely due to demographic effects. At the regional level, this demographic impact ranged from about -3 % to +41 %. There is a clear urban-rural distinction and the 28 regions with the strongest increase are all rural regions.
  
  
  CONCLUSIONS
  The substantial demographic impact in combination with strong urban-rural variations should be accounted for in regional long-term planning as well as age-group specific innovation in the emergency medical services. As demography is not the only significant demand factor, the identification and quantification of other factors remains a challenge for further research.
authors.affiliation: Institute for Emergency Medicine and Management in Medicine - INM, Klinikum der Universität München, Schillerstr. 53, 80336 Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Veser
authors.affiliation: Institute for Emergency Medicine and Management in Medicine - INM, Klinikum der Universität München, Schillerstr. 53, 80336 Munich, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Sieber
authors.affiliation: Institute for Emergency Medicine and Management in Medicine - INM, Klinikum der Universität München, Schillerstr. 53, 80336 Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Groß
authors.affiliation: Institute for Emergency Medicine and Management in Medicine - INM, Klinikum der Universität München, Schillerstr. 53, 80336 Munich, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Prückner
keywords: Demand trends; Demography; Emergency medical services; Regional health planning; Socioeconomic factors; Urban–rural differences