[Using claims data for small area analysis and controlling of hospital care]

Abstract

In Germany, only few data sources enable a small-area analysis of medical care. However, this is necessary for empirically based planning of future medical care. Here claims data of the statutory health insurance provide new insights into medical care by utilization analysis at district and postal zip code levels. Examples of small-area analysis of hospital care show manifold possibilities of using these data for purposes of health services research and planning. The most important result of these analyses is the considerable variation of hospital care utilization which is constant over time and regions. Claims data are updated regularly, complete, unbiased, and of high quality. They also have a clear reference to population and region. Limitations of using claims data arise from the absence of clinical information. For purposes of hospital planning the restriction to the hospital sector is more important. In the future this limitation will be overcome by using claims data from primary and hospital care together.