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On the interdependence of ambulatory and hospital care in the German health system

Author

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  • Tugba Büyükdurmus

    (Universität Duisburg-Essen
    CINCH - National Research Center for Health Economics
    RWI - Leibniz-Institut für Wirtschaftsforschung
    Ruhr-Universität Bochum)

  • Thomas Kopetsch

    (Kassenärztliche Bundesvereinigung)

  • Hendrik Schmitz

    (CINCH - National Research Center for Health Economics
    Universität Paderborn)

  • Harald Tauchmann

    (CINCH - National Research Center for Health Economics
    RWI - Leibniz-Institut für Wirtschaftsforschung
    Friedrich-Alexander-Universität Erlangen-Nürnberg)

Abstract

For some considerable time now the interface between ambulatory and hospital care has been mooted as a cause of inefficiencies in the German health system and there have been calls for a softening of the strict separation between the two sectors. This debate emphasizes the need for detailed empirical information on the interdependence between the two sectors. Using extensive administrative data at the level of the 412 German counties for the years 2007 to 2009 and a simultaneous equation model which allows the numbers of ambulatory and hospital cases to be mutually interdependent, we examine the connection between ambulatory and hospital specialist care separately for ten medical specialties. The results show that the interdependence of ambulatory and hospital services is far from homogeneous. The relationship depends, on the one hand, on the specialty and, on the other, on the direction of the effect observed. This heterogeneity needs to be taken into account for cross-sector needs-based planning.

Suggested Citation

  • Tugba Büyükdurmus & Thomas Kopetsch & Hendrik Schmitz & Harald Tauchmann, 2017. "On the interdependence of ambulatory and hospital care in the German health system," Health Economics Review, Springer, vol. 7(1), pages 1-19, December.
    • Handle: RePEc:spr:hecrev:v:7:y:2017:i:1:d:10.1186_s13561-016-0132-4
    DOI: 10.1186/s13561-016-0132-4
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    References listed on IDEAS

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    Cited by:

    1. Wende, Danny & Kopetsch, Thomas & Richter, Wolfram F., 2020. "Planning health care capacities with a gravity equation," Ruhr Economic Papers 888, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    2. Wende, Danny & Kopetsch, Thomas & Richter, Wolfram F., 2021. "A Demand-Oriented Approach to Health Care Capacity Planning," IZA Discussion Papers 14860, Institute of Labor Economics (IZA).

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