Endometrioseversorgung in Deutschland – Patientinnenerfahrungen und räumliche Analysen der stationären Versorgung
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Abstract
Background:
Endometriosis is a chronic gynaecological condition that is associated with stigmatisation and long diagnostic pathways. Despite the German guideline and its recommendations for diagnostic and treatment, there are deficits in the healthcare system.
Aim:
Therefore, the aim of this dissertation was to identify the challenges and resources in endometriosis care using a mixed-methods approach. A qualitative investigation was conducted to determine healthcare experiences from the patients' perspective, and a quantitative analysis was carried out to map the spatial distribution of inpatient care in Germany.
Method:
For the qualitative analysis, 21 semi-structured interviews were conducted with patients and evaluated using an interpretative phenomenological approach. In the quantitative part, inpatient care was analysed based on the 2021 hospital quality reports. Hospital location and case numbers of certified endometriosis centres and non-certified hospitals were determined. In addition, travel times and spatial clusters were determined using
Global and Local Moran’s I.
Results:
The interviews revealed the ambivalence regarding healthcare experiences by patients. On the one hand, these were characterised by trivialisation and a lack of recognition of symptoms, and on the other hand, by empathetic and supportive providers. The spatial analysis showed a cluster of high case numbers in urban regions and low case numbers especially in eastern Germany and rural areas. With a travel time of 60 minutes to certified centres, the entire area of Germany was not covered.
Discussion:
The study results illustrate that individual, communicative, and structural barriers exist in the treatment of endometriosis. The heterogeneous regional distribution of specialised centres, problems in patient-provider-communication, and a lack of public awareness contribute to inequalities in care.
Conclusion:
In order to archive patient-centred, gender-sensitive and comprehensive healthcare, structural reforms and initiatives such as sensitising medical staff should be implemented.
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This item has been published with the following license: In Copyright