Der Zusammenhang zwischen Physiotherapieverordnungen und der Arztdichte in Deutschland. Eine Sekundärdatenanalyse der Jahre 2006 bis 2016

Purpose Physiotherapeutic treatments are the most frequently prescribed remedies in Germany. However, the quantity of their prescription varies substantially between federal states. Physician density also varies considerably. In this study we therefore wanted to examine the quantitative relationship between physician density and physiotherapy prescriptions in Germany between 2006 and 2016. Methods The data are based on secondary data from the Central Association of German Medical Association and the Statutory Health Insurance. The analysis and presentation of the data collected at federal state level is carried out descriptively using graphs and tables. To examine the relationship between physiotherapy prescriptions and physician density, both Pearson's correlation and a mixed linear model are used. Results If only the physician density and the total number of physiotherapy prescriptions are considered, there is no correlation (r=-0.004; p=0.988). This is also confirmed by considering further influences in a mixed linear model (R2=0.95; p=0.248). Furthermore, the average prescription volumes per physician and year vary considerably between the federal states (1,033-3,054 treatment sessions). Physician density and physiotherapy prescriptions both increased between 2006 and 2016 across all federal states (increase rates: 0.6-16% and 5-56%, respectively). Discussion In addition to physician density, other factors, such as regionally different health conditions of the population and different budget volumes of prescribing physicians, are possible influencing factors on prescription numbers. Although no geographical patterns can be identified among the physiotherapy prescriptions, the physician density in the city states is particularly high. Physiotherapy prescriptions per physician in the Eastern Germany states are above the national average which, in contrast to the total number of prescriptions, could be due to the low relative physician density. Conclusion No correlation between physician density and total prescription numbers of physiotherapy prescriptions could be identified. In order to ensure a demand-based supply of physiotherapeutic treatments, existing regional influencing factors should be taken into consideration in future studies.