title: [Optimization of Community Health Care: First Experiences of the Office for Medical Care in Districts and Municipalities of Bavaria].
abstract: Background:Demographic changes pose serious challenges for the healthcare system. One important goal is to sustain the local healthcare provision in the future - especially in rural areas. In this context, more attention must be given to the statutory health service by communal as well as state authorities. Most of the municipalities have to tackle this problem for the first time and, due to lack of support, are faced with serious impediments. The aim of this paper is to describe the sphere of action of the Office for Medical Care in Districts and Municipalities (OMCDM) as well as its core outcome.Methods:The Bavarian Ministry of Health and Care (StMGP) established the OMCDM at the Bavarian Health and Food Safety Authority to support communal authorities. On behalf of the StMGP, this office analyses the existing set-ups of local health services and advises local authorities on improvement. For 2012-2015, the OMCDM database was analyzed for frequency and main reasons of contact with health services.Results:The action of the OMCDM is driven by a comprehensive assessment, specialist counseling, and networking to develop action potential for the individual local health authorities. Over the past four years, there has been an increasing demand for support. Until 2015-11-30, 233 cases of counseling and 155 intensive counseling cases were recorded. The topics most frequently mentioned in these consultations were primary care by General Practitioners (68%) and specialist care (29%). Other important issues were the search for successors (33%), the establishment of new practices (23%) and opening of branch practices (18%).Conclusion:On behalf of Bavarian government, the OMCDM offers easy access to objective and neutral counseling about statutory health services for Bavarian municipalities. This offer has been used frequently by districts and municipalities. Primary care by general practitioners on the local level was the most common reason to contact the OMCDM. The establishment of the Office for Medical Care in Districts and Municipality is a comprehensive support for local authorities and can be regarded as a pattern for other states in Germany.
authors.affiliation: Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Sachgebiet Versorgungsqualität, Gesundheitsökonomie, Gesundheitssystemanalyse (GE 6), Nürnberg.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Geuter
authors.affiliation: Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Sachgebiet Versorgungsqualität, Gesundheitsökonomie, Gesundheitssystemanalyse (GE 6), Nürnberg.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ewert
authors.affiliation: Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Sachgebiet Versorgungsqualität, Gesundheitsökonomie, Gesundheitssystemanalyse (GE 6), Nürnberg.
authors.forename: Timo
authors.initials: T
authors.lastname: Deiters
authors.affiliation: Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Sachgebiet Versorgungsqualität, Gesundheitsökonomie, Gesundheitssystemanalyse (GE 6), Nürnberg.
authors.forename: Alfons
authors.initials: A
authors.lastname: Hollederer
mesh_terms: D002947:Cities / Q000706:statistics & numerical data*; D003153:Community Health Services / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration; D005858:Germany; D006285:Health Planning / Q000458:organization & administration*; D017146:Models, Organizational; D010865:Pilot Projects; D011634:Public Health / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*