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Western Pomerania and the North Brandenburg region are located in the far north-east of the Federal Republic of Germany, with borders adjacent to Poland. This federal state area has a population density of 70 inhabitants per square kilometre – the lowest possible margin in Germany (e.g. in comparison, the sparsely populated Upper Franconia of the old federal states has 152 inhabitants per square kilometre). The demographic changes have been particularly noticeable here due to the departure of young people, the sharp drop in birth rates after 1989, and overall lack of immigration to the area. Provision of medical care therefore had to break new ground.
While basic primary care (meaning general medical services) are certainly available, especially in the cities of the region, highly specialised disciplines with low physician numbers (e.g. radiologists, pathologists), and those fields which require high investment in equipment (e.g. radiology), find that they cannot provide enough services outside of core hours to a large catchment area. Small hospitals can definitely cover the day shifts during the week, e.g. radiological examinations; however, there are not enough patient numbers to maintain the costs for examinations during weekends or at night. The same is true for disciplines such as ophthalmology and Ear-Nose-and-Throat, among others.