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Provision of health care services and regional diversity in Germany: insights from a Bayesian health frontier analysis with spatial dependencies

Author

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  • Rouven Edgar Haschka

    (Georg-August University of Göttingen)

  • Katharina Schley

    (Georg-August University of Göttingen)

  • Helmut Herwartz

    (Georg-August University of Göttingen)

Abstract

The German health care system is among the most patient-oriented systems in Europe. Nevertheless, distinct utilisation patterns, access barriers due to socio-economic profiles, and potentials of misallocation of medical resources lead to disparities in the provision of health care services. We analyse how a possible over- and undersupply of services and the utilisation of and the access to the health care system relate to regional variations in the population’s well-being. For this purpose, we employ a recent Bayesian stochastic frontier approach that allows for spatial dependence structures. Our results indicate that patient migration plays an important role in contributing to regional differences in the utilisation of the medical infrastructure. As a consequence, policy should take spatial patterns of health care utilisation into account to improve the allocation of medical resources.

Suggested Citation

  • Rouven Edgar Haschka & Katharina Schley & Helmut Herwartz, 2020. "Provision of health care services and regional diversity in Germany: insights from a Bayesian health frontier analysis with spatial dependencies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 55-71, February.
    • Handle: RePEc:spr:eujhec:v:21:y:2020:i:1:d:10.1007_s10198-019-01111-9
    DOI: 10.1007/s10198-019-01111-9
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    2. Rouven E. Haschka, 2024. "Endogeneity in stochastic frontier models with 'wrong' skewness: copula approach without external instruments," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 33(3), pages 807-826, July.
    3. Rouven E. Haschka & Helmut Herwartz & Clara Silva Coelho & Yabibal M. Walle, 2023. "The impact of local financial development and corruption control on firm efficiency in Vietnam: evidence from a geoadditive stochastic frontier analysis," Journal of Productivity Analysis, Springer, vol. 60(2), pages 203-226, October.
    4. Fang Wu & Mingyao Gu & Chenming Zhu & Yingna Qu, 2023. "Temporal-Spatial Evolution and Trend Prediction of the Supply Efficiency of Primary Medical Health Service—An Empirical Study Based on Central and Western Regions of China," IJERPH, MDPI, vol. 20(3), pages 1-23, January.
    5. Cristian Barra & Nazzareno Ruggiero, 2022. "How do dimensions of institutional quality improve Italian regional innovation system efficiency? The Knowledge production function using SFA," Journal of Evolutionary Economics, Springer, vol. 32(2), pages 591-642, April.
    6. Boffardi, Raffaele, 2022. "How efficient is the Italian health system? Evidence on the role of political-institutional dynamics," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    7. Rouven E. Haschka & Helmut Herwartz, 2022. "Endogeneity in pharmaceutical knowledge generation: An instrument‐free copula approach for Poisson frontier models," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 31(4), pages 942-960, November.

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    More about this item

    Keywords

    Health production; Health efficiency; Stochastic frontier analysis; Oversupply of medical services; Regional misallocation; Bayesian estimation; Regional and spatial modelling; Markov-chain–Monte Carlo simulation;
    All these keywords.

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • R10 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - General Regional Economics - - - General

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