REGIONAL VARIATION IN THE UTILISATION OF AMBULATORY SERVICES IN GERMANY
Article first published online: 2 OCT 2013
Copyright © 2013 John Wiley & Sons, Ltd.
Volume 23, Issue 12, pages 1481–1492, December 2014
How to Cite
2014), REGIONAL VARIATION IN THE UTILISATION OF AMBULATORY SERVICES IN GERMANY, Health Econ., 23, 1481–1492, doi:10.1002/hec.3001., and (
- Issue published online: 5 NOV 2014
- Article first published online: 2 OCT 2013
- Manuscript Accepted: 2 SEP 2013
- Manuscript Revised: 15 FEB 2013
- Manuscript Received: 7 SEP 2012
- physician consultations;
- small-area variation;
- spatial correlations;
- instrumental variables
We used an administrative dataset covering approximately 90% of all Germans to investigate the determinants of regional differences in the utilisation of ambulatory services in the year 2008. There are great regional differences in Germany, in GP, specialist and psychotherapist consultations. By means of a regression model taking account of the spatial dependencies of the error terms, we can explain a considerable part of the variation in terms of differences in demography, health status and socio-economic features. In addition, we made use of data on pollutants, the supply of services and the number of hospital cases as explanatory variables, which all have a significant influence on utilisation but contribute considerably less to explaining the differences. Overall, we are in a position to explain 29–40% of the regional differences in ambulatory case numbers at the level of the 413 counties and 55–70% at the level of the 16 German states (Länder) by observable differences. Copyright © 2013 John Wiley & Sons, Ltd.