Regional differences in health care of patients with inflammatory bowel disease in Germany

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Lange, Ansgar; Prenzler, Anne; Bachmann, O.; Linder, R.; Neubauer, Sarah et al.: Regional differences in health care of patients with inflammatory bowel disease in Germany. In: Health Economics Review 5 (2015), Nr. 1, 29. DOI:

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Sum total of downloads: 101

Background: The regional availability of specialized physicians is an important aspect in healthcare of patients with IBD. The association between physician density and healthcare is not yet clear. Most studies did not consider district type, which reflects population density. Our research question was, “Do specialist density and district type influence the healthcare of IBD patients in Germany?” Methods: We combined a claims dataset from a German health insurance fund with population and physician data. Four main aspects were investigated: regular specialist visits, drug therapies, surveillance colonoscopy, and IBD-related hospitalizations. Various regression analyses were performed. Results: The study cohort was comprised of 21,771 individuals, including 9282 patients with Crohn disease and 12,489 patients with ulcerative colitis. Patients who were living in districts with higher specialist densities were more likely to attend specialist visits on a regular basis. No difference in the frequencies of TNF-alpha inhibitor therapies was found. However, individuals from urban areas were more likely to receive a permanent immunosuppressive therapy with continuous specialist support. Conclusions: The results revealed that some aspects had positive effects on the probability of implementing healthcare in accordance with pathways and guidelines. No clear evidence of a general healthcare undersupply in rural areas was found.
License of this version: CC BY 4.0
Document Type: article
Publishing status: publishedVersion
Issue Date: 2015
Appears in Collections:Wirtschaftswissenschaftliche Fakultät

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downloads by country:

pos. country downloads
total perc.
1 image of flag of Germany Germany 93 92.08%
2 image of flag of Albania Albania 3 2.97%
3 image of flag of United States United States 1 0.99%
4 image of flag of France France 1 0.99%
5 image of flag of Algeria Algeria 1 0.99%
6 image of flag of China China 1 0.99%
7 image of flag of Switzerland Switzerland 1 0.99%

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