Abstract
BackgroundThis 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.MethodWe 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.ResultsImprovements in remaining life expectancy at older ages were first seen in towns with university hospitals, where state-of-the-art services became available first.ConclusionOur 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.
Highlights
There is no definitive answer to the question of whether increased spending on health care results in better health outcomes
We investigate whether rising investments in the modernization of the health care system in East Germany contributed to improving life expectancy levels
Between 1982 and 2007, remaining life expectancy among older females over age 65 in East German university towns rose from 15.2 years to 20.9 years compared with an increase from 15.0 years to 20.2 years among older women in the rest of East Germany
Summary
There is no definitive answer to the question of whether increased spending on health care results in better health outcomes. There is a general association between rising life expectancy and increasing health care spending over time, it is less clear whether rising medical investments are really the trigger for improving population health. The quality and efficiency of health care delivery are more important than the level of spending per se for improvements in health and survival [1,2,3]. We investigate whether rising investments in the modernization of the health care system in East Germany contributed to improving life expectancy levels. This article investigates the importance of regional health care availability for old age survival.
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