LäKoSA – Ländliche Kohorte Sachsen-Anhalt (Rural Cohort Saxony-Anhalt) - Monitoring the state and quality of healthcare in rural northern Saxony-Anhalt– A cohort study

The rural area of northern Saxony-Anhalt is already affected by demographic change. The main challenges include a growing shortage of doctors, limited access to medical care, and a weakly developed (digital) infrastructure (Fuchs und Fritzsche 2022; Barthen und Gerlinger 2016; Stachwitz und Debatin 2023; Landesportal Sachsen-Anhalt 2025). Older population groups in particular depend on accessible and quickly available healthcare services, but are especially at risk due to limited mobility and lower (digital) health literacy (van den Berg et al. 2024; Rind et al. 2025). This leads to concerns about ensuring needs-based healthcare provision. New forms of care, such as telemedicine and improved networking among local stakeholders, are promising approaches for achieving sustainable healthcare provision (Krajewski & Wiegandt 2020; Stachwitz & Debatin 2023). In order to assess, monitor and evaluate the long-term healthcare provision and quality in the study region, a population-based cohort of individuals aged 40 and above will be established in two districts of northern Saxony-Anhalt. The cohort will be surveyed in writing and online questionnaires in four waves at six-month intervals until December 2027, covering alternating topics. The first wave of data collection focuses on assessing the utilization of health services (general practitioners, specialists, therapists, emergency care), access to healthcare facilities (travel time and means of transport), patient assessment of care, the mental and physical health of the population, social support, and health-related quality of life. Both validated instruments and self-developed items were used where no validated instruments were available. All non-validated items included in the questionnaire underwent prior content validation. In subsequent waves, specific aspects of psychosocial care as well as intensive and emergency medical care will be examined. The cohort also serves to evaluate facilitating and hindering factors (e.g., health literacy) for the implementation of new models of care (e.g., telemedicine).