Design and methodology of the Geo-social Analysis of Physicians’ settlement (GAP-Study) in Germany

BACKGROUND Unequally distributed disease burdens within populations are well-known and occur worldwide. They are depending on residents' social status and/or ethnic background. Country-specific health care systems - especially the coverage and distribution of health care providers - are both a potential cause as well as an important solution for health inequalities. METHODS Registers are built of all accredited physicians and psychotherapists within the outpatient care system in German metropolises by utilizing the database of the Associations of Statutory Health Insurance Physicians. The physicians' practice neighborhood will be analyzed under socioeconomic and demographic perspectives. Therefore, official city districts' statistics will be assigned to the physicians and psychotherapists according to their practice location. Averages of neighborhood indicators will be calculated for each specialty. Moreover, advanced studies will inspect differences by physicians' gender or practice type. Geo-spatial analyses of the intra-city practices distribution will complete the settlement characteristics of physicians and psychotherapists within the outpatient care system in German metropolises. RESULTS The project "Geo-social Analysis of Physicians' settlement" (GAP) is designed to elucidate gaps of physician coverage within the outpatient care system, dependent on neighborhood residents' social status or ethnics in German metropolises. CONCLUSION The methodology of the GAP-Study enables the standardized investigation of physicians' settlement behavior in German metropolises and their inter-city comparisons. The identification of potential gaps within the physicians' coverage should facilitate the delineation of approaches for solving health care inequality problems.