title: The importance of regional availability of health care for old age survival - Findings from German reunification.
abstract: BACKGROUND
  This article investigates the importance of regional health care availability for old age survival. Using German reunification as a natural experiment, we show that spatial variation in health care in East Germany considerably influenced the convergence of East German life expectancy toward West German levels.
  
  
  METHODS
  We apply cause-deleted life tables and continuous mortality decomposition for the years 1982-2007 to show how reductions in circulatory mortality among the elderly affected the East German catch-up in life expectancy.
  
  
  RESULTS
  Improvements in remaining life expectancy at older ages were first seen in towns with university hospitals, where state-of-the-art services became available first.
  
  
  CONCLUSIONS
  Our results suggest that the modernization of the health care system had a substantial effect on old-age life expectancy and helped to significantly reduce circulatory diseases as the main cause of death in East Germany.
authors.affiliation: Max Planck Institute for Demographic Research Konrad-Zuse-Str. 1, 18057 Rostock, Germany.
authors.forename: Tobias C
authors.initials: TC
authors.lastname: Vogt
authors.affiliation: Max Planck Institute for Demographic Research Konrad-Zuse-Str. 1, 18057 Rostock, Germany.
authors.forename: James W
authors.initials: JW
authors.lastname: Vaupel
keywords: Circulatory mortality; Germany; Health Care Quality; Life expectancy; Natural experiment