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      The importance of regional availability of health care for old age survival - Findings from German reunification

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          Abstract

          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.

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          Measuring the quality of medical care. A clinical method.

          D Rutstein, F E Perrin, W Berenberg … (1976)
          We outline the implementation of a new method of measuring the quality of medical care that counts cases of unnecessary disease and disability and unnecessary untimely deaths. First of all, conditions are listed in which the occurrence of a single case of disease or disability or a single untimely death would justify asking, "Why did it happen?" Secondly, we have selected conditions in which critical increases in rates of disease, disability, or untimely death could serve as indexes of the quality of care. Finally, broad categories of illness are noted in which redefinition and intensive study might reveal characteristics that could serve as indexes of health. We describe how these inth of the general population and the effects of economic, political, and other environmental factors upon it, and to evaluate the quality of medical care provided both within and without the hospital to maintain health and to prevent and treat disease.
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            The value of medical spending in the United States, 1960-2000.

            Jodi Cutler, Sandeep Vijan, Lindsey B. Rosen (2006)
            The increased use of medical therapies has led to increased medical costs. To provide insight into the value of this increased spending, we compared gains in life expectancy with the increased costs of care from 1960 through 2000. We estimated life expectancy in 1960, 1970, 1980, 1990, and 2000 for four age groups. To control for the influence of nonmedical factors on survival, we assumed in our base-case analysis that 50 percent of the gains were due to medical care. We compared the adjusted increases in life expectancy with the lifetime cost of medical care in the same years. From 1960 through 2000, the life expectancy for newborns increased by 6.97 years, lifetime medical spending adjusted for inflation increased by approximately 69,000 dollars, and the cost per year of life gained was 19,900 dollars. The cost increased from 7,400 dollars per year of life gained in the 1970s to 36,300 dollars in the 1990s. The average cost per year of life gained in 1960-2000 was approximately 31,600 dollars at 15 years of age, 53,700 dollars at 45 years of age, and 84,700 dollars at 65 years of age. At 65 years of age, costs rose more rapidly than did life expectancy: the cost per year of life gained was 121,000 dollars between 1980 and 1990 and 145,000 dollars between 1990 and 2000. On average, the increases in medical spending since 1960 have provided reasonable value. However, the spending increases in medical care for the elderly since 1980 are associated with a high cost per year of life gained. The national focus on the rise in medical spending should be balanced by attention to the health benefits of this increased spending. Copyright 2006 Massachusetts Medical Society.
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              Reductions in Mortality at Advanced Ages: Several Decades of Evidence from 27 Countries

              Vaino Kannisto, Jens Lauritsen, A. Roger Thatcher … (1994)
              Article 0 comments Cited 50 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Tobias C. Vogt: vogt@demogr.mpg.de
                Journal
                Journal ID (nlm-ta): Popul Health Metr
                Journal ID (iso-abbrev): Popul Health Metr
                Title: Population Health Metrics
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1478-7954
                Publication date (Electronic): 29 September 2015
                Publication date PMC-release: 29 September 2015
                Publication date Collection: 2015
                Volume: 13
                Electronic Location Identifier: 26
                Affiliations
                Max Planck Institute for Demographic Research Konrad-Zuse-Str. 1, 18057 Rostock, Germany
                Article
                Publisher ID: 60
                DOI: 10.1186/s12963-015-0060-2
                PMC ID: 4588495
                PubMed ID: 26425117
                SO-VID: c850d0c6-8586-4d05-a10a-1bf2819e7ebb
                Copyright © © Vogt and Vaupel. 2015
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 11 February 2015
                Date accepted : 21 September 2015
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2015

                ScienceOpen disciplines: Health & Social care
                Keywords: life expectancy,circulatory mortality,health care quality,germany,natural experiment
                Data availability:
                ScienceOpen disciplines: Health & Social care
                Keywords: life expectancy, circulatory mortality, health care quality, germany, natural experiment

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