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DOI: 10.1055/a-2683-9705
Original Article

Inpatient Endometriosis Care in Germany: Hospital Caseloads and their Spatial Distribution

Article in several languages: English | deutsch

Authors

  • Lara Brauer 

    1   Institut für Gesundheitsversorgungsforschung und Klinische Epidemiologie, Philipps-Universität Marburg, Fachbereich 20 Medizin, Marburg, Germany

  • Limei Ji

    1   Institut für Gesundheitsversorgungsforschung und Klinische Epidemiologie, Philipps-Universität Marburg, Fachbereich 20 Medizin, Marburg, Germany

  • Max Geraedts

    1   Institut für Gesundheitsversorgungsforschung und Klinische Epidemiologie, Philipps-Universität Marburg, Fachbereich 20 Medizin, Marburg, Germany
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Abstract

Background

Endometriosis is a chronic gynaecological disease with an estimated prevalence of 10–15%. The German guideline provides evidence-based recommendations for diagnosis and treatment, but care provided is inadequate care due to long diagnostic pathways. Recent German research focused on regional variations in outpatient care, however research on inpatient endometriosis care is still lacking.

Aim of the Study

The aim of the study was to examine inpatient endometriosis care – hospital locations and their caseloads. Spatial coverage, caseload distribution patterns and possible clusters, including certified endometriosis centres (CEC) and non-certified hospitals nationwide were analysed.

Method

German hospital quality report data from 2021 was used as data source. The location, certification status and caseload, meaning coded ICD-10 N80 Endometriosis cases, were collected for all hospitals. Then, 20-, 40- and 60-minutes’ drive radius of CEC and non-certified hospitals were determined. Global and Local Moran’s I was calculated to assess spatial clusters in caseload.

Results

A CEC 60-minutes’ drive radius covers 78.15% of the area in Germany. Including all hospital locations that coded endometriosis, a maximum driving time of 40-minutes provides almost nationwide coverage. High caseload clusters appeared in urban areas and low caseload clusters especially in eastern Germany.

Conclusion

The results indicate spatial clusters in providers caseload and difficulties in access to CEC for patients depending on location. Further research with patient-level data is needed to investigate the spatial distribution of patients and precise travel time for inpatient care.

Keywords

endometriosis - health services research - spatial distribution - German hospital quality reports

Supplementary Material

Zusätzliches Material



Publication History

Received: 06 March 2025

Accepted: 12 June 2025

Article published online:
03 November 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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