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Sources of regional variation in healthcare utilization in Germany

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  • Salm, Martin
  • Wübker, Ansgar

Abstract

We examine sources of regional variation in ambulatory care utilization in Germany. We exploit patient migration to examine which share of regional variation in ambulatory care utilization can be attributed to demand factors and to supply factors, respectively. Based on administrative claim-level data we find that regional variation can be overwhelmingly explained by patient characteristics. Our results contrast with previous results for other countries, and they suggest that institutional rules in Germany successfully constrain supply-side variation in ambulatory care use between German regions for most patients. Furthermore, we find that both demographics and other patient characteristics substantially contribute to regional variation and that causes of regional variation vary when comparing different regions within Germany.

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  • Salm, Martin & Wübker, Ansgar, 2020. "Sources of regional variation in healthcare utilization in Germany," Journal of Health Economics, Elsevier, vol. 69(C).
    • Handle: RePEc:eee:jhecon:v:69:y:2020:i:c:s016762961830866x
    DOI: 10.1016/j.jhealeco.2019.102271
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    4. Feras Kasabji & Alaa Alrajo & Ferenc Vincze & László Kőrösi & Róza Ádány & János Sándor, 2020. "Self-Declared Roma Ethnicity and Health Insurance Expenditures: A Nationwide Cross-Sectional Investigation at the General Medical Practice Level in Hungary," IJERPH, MDPI, vol. 17(23), pages 1-17, December.
    5. Jakub Cerveny & Jan C. van Ours, 2022. "Long-term returns to local health-care spending," Tinbergen Institute Discussion Papers 22-072/V, Tinbergen Institute.
    6. Wende, Danny & Kopetsch, Thomas & Richter, Wolfram F., 2020. "Planning health care capacities with a gravity equation," Ruhr Economic Papers 888, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    7. Naimi Johansson & Mikael Svensson, 2022. "Regional variation in prescription drug spending: Evidence from regional migrants in Sweden," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1862-1877, September.
    8. Cavazza, Marianna & Vecchio, Mario Del & Fattore, Giovanni & Fenech, Lorenzo, 2023. "Geographical variation in the use of private health insurance in a predominantly publicly-funded system," Health Policy, Elsevier, vol. 130(C).
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    More about this item

    Keywords

    Healthcare spending; Regional variation; Germany;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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