title: Analyzing regional variation in health care utilization using (rich) household microdata.
abstract: This paper exploits rich SOEP microdata to analyze state-level variation in health care utilization in Germany. Unlike most studies in the field of the Small Area Variation (SAV) literature, our approach allows us to net out a large array of individual-level and state-level factors that may contribute to the geographic variation in health care utilization. The raw data suggest that state-level hospitalization rates vary from 65 to 165 percent of the national mean. Ambulatory doctor visits range from 90 to 120 percent of the national mean. Interestingly, in the former GDR states, doctor visit rates are significantly below the national mean, while hospitalization rates lie above the national mean. The significant state-level differences vanish once we control for individual-level socio-economic characteristics, the respondents' health status, their health behavior as well as supply-side state-level factors.
authors.affiliation: DIW Berlin, Mohrenstrasse 58, 10117 Berlin, Germany; University of Hamburg, Germany. Electronic address: peibich@diw.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Eibich
authors.affiliation: Cornell University, Policy Analysis and Management (PAM), 106 Martha van Rensselaer Hall, Ithaca, NY 14853, United States; DIW Berlin, Germany; IZA Bonn, Germany. Electronic address: nrz2@cornell.edu.
authors.forename: Nicolas R
authors.initials: NR
authors.lastname: Ziebarth
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data; D003625:Data Collection; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005191:Family Characteristics; D062306:Geography, Medical; D005858:Germany / Q000453:epidemiology; D015438:Health Behavior; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D017059:Models, Econometric; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012959:Socioeconomic Factors
keywords: Health care utilization; I11, I12, I14, I18; SOEP; Small Area Variation