Where Will Patients Go? A Network Simulation of General Practitioner Closures and Patient Displacement in Czechia

Bety Ukolova, Charles University, Faculty of Science, Department of Demography and Geodemography
Lukáš Kahoun , Charles University, Faculty of Science
Alexander O.K. Marin, The Interdisciplinary Centre on Population Dynamics

Background: Population of general practitioners (GPs) in Czechia with an average age of 55 is one of the oldest in Europe. Coupled with low interest to becoming GP from younger medics, this raises concerns about the ability to adapt to workforce decline in face of raise of healthcare demand related to population aging. Objective: To identify how patients in Czechia adapt to the shrinking GP workforce, highlight regions at risk of being unable to provide local primary healthcare, and identify GPs who benefit the system by absorbing displaced patient cohorts. Method and Data: Using full-population data from the Czech health registries we build a network of GPs linked by their shared patients. The strength of the link between two GPs is given by the proportion of a GPs patients that visit both GPs during 2022-2023. We simulate GP closures and analyze how effectively their patients can be absorbed by the remaining GPs, based on patient-flow patterns and local provider capacity. Results: The patients of two-thirds of GPs could immediately be absorbed by directly connected GPs with additional capacity. However, border areas show weaker resilience to GP closures. The GPs who absorb patients are found in cities and in suburban regions. Conclusion: Our results indicate that patient flows could play a critical role in assessing the impact of changes in GP supply, as they enhance the flexibility of the system. Therefore, evaluating the effects of changing GP availability requires considering both local supply and the capacity of surrounding areas.

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 Presented in Session 47. Healthcare Access, Utilization and Care Needs