Journal Article

The importance of regional availability of health care for old age survival: findings from German reunification

Vogt, T. C., Vaupel, J. W.

Population Health Metrics, 13:26, 1-8 (2015)


Keywords: Germany/GDR


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. Method 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. Conclusion 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. Keywords Life expectancy – Circulatory mortality – Health Care Quality – Germany – Natural experiment