What does the new country doctor need? - An Analytic Hierarchy Process (AHP)

Aim: In the view of the fact that the lack of physicians in rural areas is increasing, the objective of the study was the identification and valuation of selected incentives that can lead to better general conditions in rural areas for ambulatory care physicians. Method: A systematic literature search was conducted to identify potential incentives. Current arrangements of the Act to Strengthen the Care Structures of Statutory Health Insurance (GKV-VSTG) and offers of the Associations of Statutory Health Insurance Physicians were included in the research. The valuation of the selected incentives was conducted with an online-based survey. Participants were students of human medicine in 2014. The eigenvalue method of the Analytic Hierarchy Process (AHP) was used for estimation. Results: 54 completely answered questionnaires with an acceptable consistency ratio were analyzed. Seven criteria were valuated with the AHP. The criteria were presented in a rank order and interpreted in relation to their general preference. The criteria, amount of economic risc" with a weight (w) of 0.251 is the most important incentive for the responders to set up a practice in a rural area. Moreover incentives like, relief trough delegation" (w = 0.145),, financial incentives under compliance of certain requirements" (w = 0.136),, regulation for the emergency service" (w = 0.136) and, support through the community for the integration in the region" (w = 0.136) were also very important. The criterion, minimum period of time for practice set up", as a premise to receive a guaranteed to move to a desired sector or region at a later date (w = 0.107), is less important. On last rank was the criterion, support for physician networks by the Association of Statutory Health Insurance Physicians" (w = 0.088). Conclusion: The results show what future country doctors need. Particularly collective medical practice concepts, with a loweconomic risk for the physicians and the support of balance between work and familiy life are favored. The results also confirm that the past activities of the Act to Strengthen the Care Structures of Statutory Health Insurance (GKV-VSTG) and the initiatives of some regional Associations of Statutory Health Insurance Physicians were steps in the right direction.