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However, access to RT services varies significantly across regions. This study aims to assess and stress-test the geospatial distribution of radiation oncology centers (ROCs) in Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Geospatial analysis was used to calculate travel times and distances and to calculate regional RT demand. A\u00a0regional network analysis was also conducted. Simulation of local ROC closure and recalculation was conducted to stress-test the remaining RT capacities, resulting in a\u00a0redistribution network analysis (ReDNA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>While some regions have a\u00a0higher concentration of ROCs than others, the average ROC usually serves a\u00a0population of approximately 238,185\u00a0inhabitants. In urban regions, the average travel time to the nearest ROC was 7.9\u202fmin, compared to 11.4\u202fmin in rural regions. However, the heterogeneity increases when considering the second- or third-closest ROC, especially in rural regions. The regional ReDNA identified regions with high vulnerability to local ROC disruption. In these areas, the closure of a\u00a0single ROC probably leads to significant increases in travel times for patients. Inhabitants of cities\/towns in rural regions are specifically dependent on the serviceability of their ROC, with a\u00a0relative increase in travel time by 171.9% if the currently nearest ROC is closed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>For the first time, this study investigates the supply of RT services on a\u00a0national level. The spatial accessibility of RT services is analyzed by regional types as well as by federal states. The novel ReDNA approach allows regions with potential vulnerabilities to be identified, resulting in a\u00a0framework for stress-testing RT supply on a\u00a0national level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This research provides valuable insights into the spatial accessibility and vulnerability of radiation oncology services in Germany. Additionally, the methodology can also serve as a\u00a0stress test and be applied to other regions and healthcare specialties to improve healthcare planning and patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00066-025-02435-7","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T14:12:35Z","timestamp":1753366355000},"page":"405-417","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Analysis and stress-test of the spatial accessibility to German radiation oncology centers"],"prefix":"10.1007","volume":"202","author":[{"given":"Christoph","family":"Straube","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Medenwald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8281-4838","authenticated-orcid":false,"given":"Tim","family":"Holthaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"2435_CR1","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1016\/j.healthpol.2006.05.006","volume":"80","author":"E Pagano","year":"2007","unstructured":"Pagano\u00a0E, Cuonzo\u00a0DD, Bona\u00a0C et\u00a0al (2007) Accessibility as a\u00a0major determinant of radiotherapy underutilization: A\u00a0population based study. 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