Checking on the rates of surgical procedures in Germany by telephone surveys in four selected regions

Considerable regional variation of surgical procedure rates has been report ed for a number of countries. Influential variables that have been discusse d are patient-related, physician-related and health care system-specific fa ctors. A representative computer-assisted telephone survey was conducted in four selected regions for a study sponsored by the German Federal Ministry of Health. These regions were the townships of Aachen and Hamm in North Rh ine-Westphalia and Chemnitt and Gorlitz in Saxony. During the telephone sur vey 1897 persons were contacted and 1041 interviews completed. Multiple log istic regression showed a surgical procedure frequency which was by 40% hig her in Aachen than in Hamm. During further analysis the regional localisati on was replaced by region-specific structural health care information varia bles. During this analysis the regional frequency of medical specialists wa s significant at a 5% level (odds ratio: 1.07; 95% confidence interval: 1.0 2-1.12). This result can be interpreted as an increase in surgical procedur es by 7% for each additional specialist per 10000 persons. However, no defi nite conclusion can be reached based on the available data. Intensifying th e presented survey-based health services research has the potential to iden tify regional over- or undersupply of medical services, to objectify and ac company informational, administrative or political action and thereby to su pport equity in access and health care in the sense of an optimized allocat ion of resources.