Are Mortality Improvements Associated with Increased Healthcare Utilization? Evidence from the German Diagnosis Related Groups (G-DRG) Statistics

Anna-Kathleen Piereth , Max Planck Institute for Demographic Research
Marcus Ebeling, Karolinska Institutet

Recent mortality improvements in developed countries are largely driven by successful secondary and tertiary disease prevention. Both aim to reduce severity and impact of diseases. Consequently, prevalence of multimorbidity is increasing because people are living longer with diseases and often develop more diseases at the same time. Multimorbid people require more complex medical care and are at greater risk of becoming sicker. Multimorbidity is also associated with increased healthcare needs. In view of these dynamics, it could be hypothesized that (further) improvements in mortality require more intensive healthcare utilization. We will test whether this hypothesis holds for the last 15 years in Germany and assess mortality improvements through the lens of Diagnosis Related Groups (DRGs). DRGs are created to group patients according to their disease and treatment patterns, and they are the main hospital reimbursement system in Germany and many other countries. We will combine the German DRG statistics (years 2007 to 2022) – a complete census of all cases treated in a hospital – with data from the Human Mortality Database, and examine to what extent rates of improvement in total and cause-of-death-specific death rates are associated with changes in the amount of utilized hospital care. Preliminary results show that strong mortality improvements were notably associated with relative increases in healthcare utilization. To the best of our knowledge, this is the first study that uses DRG data for demographic research, and the results will thus also reveal the potential of this internationally used coding scheme for demographic applications.

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 Presented in Session 22. Longevity and Health