Regional variation in the utilization of nursing home care in Germany

authored by: Annika Herr, Maximilian Lückemann, Amela Saric-Babin
Abstract: Approximately 32 percent of individuals aged over 64 years old, with care needs, are residing in nursing homes in Germany. However, this percentage exhibits significant regional disparities, ranging from under 15 percent in certain counties to over 50 percent in others. The purpose of this study is to elucidate the underlying factors explaining this regional variation in nursing home utilization. We employed comprehensive administrative data encompassing the entire elderly care-dependent population and all nursing homes. Our analytical approach involves the use of linear regression models at the county level, accounting for an extensive array of control variables and fixed effects. Additionally, we analyzed regional dependencies by applying spatial lag models. In summary, our model successfully predicts up to 73 percent of the observed regional variation in nursing home utilization. Key factors include care needs, the presence of informal care support and the supply of professional care. Spatial dependencies can be detected but exhibit a minor influence on these variations controlling for care needs. Noteworthy, enabling factors, such as a region’s wealth or rurality, have a very limited impact in a country with a generous social insurance system that covers care for those with limited financial resources.
Organisation(s): Institute of Health Economics
External Organisation(s): University of Duisburg-Essen
University Hospital Düsseldorf
Type: Article
Journal: European Journal of Health Economics
No. of pages: 20
ISSN: 1618-7598
Publication date: 25.11.2024
Publication status: E-pub ahead of print
Peer reviewed: Yes
ASJC Scopus subject areas: Economics, Econometrics and Finance (miscellaneous), Health Policy
Sustainable Development Goals: SDG 3 - Good Health and Well-being
Electronic version(s): https://doi.org/10.1007/s10198-024-01732-9 (Access: Open)

BibTeX

@article{813b22fe186543d1b7254dc571289d55,
title = "Regional variation in the utilization of nursing home care in Germany",
abstract = "Approximately 32 percent of individuals aged over 64 years old, with care needs, are residing in nursing homes in Germany. However, this percentage exhibits significant regional disparities, ranging from under 15 percent in certain counties to over 50 percent in others. The purpose of this study is to elucidate the underlying factors explaining this regional variation in nursing home utilization. We employed comprehensive administrative data encompassing the entire elderly care-dependent population and all nursing homes. Our analytical approach involves the use of linear regression models at the county level, accounting for an extensive array of control variables and fixed effects. Additionally, we analyzed regional dependencies by applying spatial lag models. In summary, our model successfully predicts up to 73 percent of the observed regional variation in nursing home utilization. Key factors include care needs, the presence of informal care support and the supply of professional care. Spatial dependencies can be detected but exhibit a minor influence on these variations controlling for care needs. Noteworthy, enabling factors, such as a region{\textquoteright}s wealth or rurality, have a very limited impact in a country with a generous social insurance system that covers care for those with limited financial resources.",
keywords = "C23, I11, I18, Long-term care, Nursing home, Regional variation, Spatial panel data models",
author = "Annika Herr and Maximilian L{\"u}ckemann and Amela Saric-Babin",
note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",
year = "2024",
month = nov,
day = "25",
doi = "10.1007/s10198-024-01732-9",
language = "English",
journal = "European Journal of Health Economics",
issn = "1618-7598",
publisher = "Springer Verlag",
}