ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2013
What accounts for the regional differences in the utilisation of hospitals in Germany?
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Cancer care: incidence, hospitalization and medical rehabilitation statistics for Germany from 2003 to 2016.BMC health services research · 2026Article
- Regional variation in the utilization of nursing home care in Germany.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- Ikigai as a Personal Resource for Work Engagement: A Cross-Sectional Study Among Nursing Trainees in Germany.Nursing reports (Pavia, Italy) · 2025Article
- Lower ambulatory care availability and greater hospital capacity are associated with higher hospital case volumes.Research in health services & regions · 2025Article
- Article
- Evaluating public interest in herpes zoster in Germany by leveraging the internet: a retrospective search data analysis.BMC public health · 2023Article
- Geographical differences of carbapenem non-susceptible Enterobacterales and Acinetobacter spp. in Germany from 2017 to 2019.Antimicrobial resistance and infection control · 2022Article
- Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018).The Lancet regional health. Europe · 2022Article
- Regional variation of potentially avoidable hospitalisations in Switzerland: an observational study.BMC health services research · 2021Observational
- Provision of health care services and regional diversity in Germany: insights from a Bayesian health frontier analysis with spatial dependencies.The European journal of health economics : HEPAC : health economics in prevention and care · 2020Article
- Trends and regional variation in rates of orthopaedic surgery in Germany: the impact of competition.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Article
- Prevalence, Mortality, and Indicators of Health Care Supply-Association Analysis of Cardiovascular Diseases in Germany.Frontiers in cardiovascular medicine · 2018Article
- On the interdependence of ambulatory and hospital care in the German health system.Health economics review · 2017Article
- [Otorhinolaryngology in the field of demography, growing outpatient care and regionalization].HNO · 2017Article
- The impact of office-based care on hospitalizations for ambulatory care sensitive conditions.The European journal of health economics : HEPAC : health economics in prevention and care · 2015Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There are huge regional variations in the utilisation of hospital services in Germany. In 2007 and 2008 the states of Hamburg and Baden-Württemberg had on average just under 38 % fewer hospitalisations per capita than Saxony-Anhalt. We use data from the DRG statistics aggregated at the county level in combination with numerous other data sources (e.g. INKAR Database, accounting data from the National Association of Statutory Health Insurance Physicians (KBV), Federal Medical Registry, Germany Hospital Directory, population structure per county) to establish the proportion of the observed regional differences that can be explained at county and state levels. Overall we are able to account for 73 % of the variation at state level in terms of observable factors. By far the most important reason for the regional variation in the utilisation of in-patient services is differences in medical needs. Differences in the supply of medical services and the substitutability of outpatient and inpatient treatment are also relevant, but to a lesser extent.
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