Regional Differences in Long-Term Care in Germany and Their Relationship with Socio-Economic Factors. A Study Based on the Concept of Disability-Free Life Expectancy

Daniel Kreft, Rostock Center for the Study of Demographic Change
Gabriele Doblhammer, Max Planck Institute for Demographic Research

This study explores spatial patterns in care need in Germany by using the Health Ratio (HR). We use the German Care Need statistics 2009, an official register of all recipients of help from the German public long-term care insurance, in combination with regional and national life table estimates and socio-economic indicators of the regional database of the German National Statistical Office. We find consistent clusters of regions with low or high HR, which extend beyond the borders of federal states and are linked to the region’s socio-economic background. Applying meta-regression models, we find effects of regional characteristics on the between-region variance. A high population density, a high mean household income, a low unemployment, and low premature mortality are significantly linked to a high HR. To our knowledge, this is the first study that for Germany shows the existence of regional differentials in care need and the resulting HR.