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


Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Vogt, TC; Vaupel, JW

Published Date

  • January 2015

Published In

Volume / Issue

  • 13 /

Start / End Page

  • 26 -

PubMed ID

  • 26425117

Pubmed Central ID

  • 26425117

Electronic International Standard Serial Number (EISSN)

  • 1478-7954

International Standard Serial Number (ISSN)

  • 1478-7954

Digital Object Identifier (DOI)

  • 10.1186/s12963-015-0060-2


  • eng