title: [Regional differences in the health care of basal cell carcinoma].
abstract: BACKGROUND
  Basal cell carcinoma (BCC) is the most common type of skin cancer in Germany. So far, it is unclear whether regional variations exist in the health care of the BCC.
  
  
  OBJECTIVE
  Analysis of regional variations in health care (e. g., skin cancer screening) and their causes using the example of BCC.
  
  
  METHODS
  Qualitative and quantitative analysis of the regional health care situation of BCC based on three studies was undertaken. These studies include the analysis of n = 7015 histopathological indications whose average tumor thickness is regarded as a characteristic of the quality of care, and a secondary data analysis of GK insured (n = 6.1 million DAK-insured persons), and a nationwide survey (FORSA) of n = 1004 participants focusing on the use of skin cancer screening.
  
  
  RESULTS
  Analysis of the histopathological examination showed regional variations in average tumor depth of penetration. These are associated with the rural/urban characteristics of the region and individual sociodemographic indicators (e. g., employment sector or education). The results for age- and gender-specific use (DAK data) showed higher participation rates regarding skin cancer screening in western than in eastern federal states (Bundesländer). Moreover, it was revealed that the trend for using skin cancer screening was higher in urban than in rural areas. The results of population-related surveys confirm this trend.
  
  
  CONCLUSIONS
  Although it is not possible to compare the studies directly, all three showed an association between city/state and the use of skin cancer screenings. In addition, sociodemographic characteristics that are related to the quality of health care were identified.
authors.affiliation: Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland. jo.augustin@uke.de.
authors.forename: J
authors.initials: J
authors.lastname: Augustin
authors.affiliation: Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
authors.forename: I
authors.initials: I
authors.lastname: Schäfer
authors.affiliation: Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Thiess
authors.affiliation: Institut für strategische Analysen in der Dermatologie (IStAD), Hamburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Reusch
authors.affiliation: Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Augustin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000706:statistics & numerical data; D015995:Prevalence; D012041:Regional Medical Programs / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D014600:Utilization Review; D055815:Young Adult
keywords: Germany; Participation; Skin cancer; Skin cancer screening; Tumor depth of penetration