Gilt Romers's Law auch in Deutschland?, Eine empirische Untersuchung zur Überprüfung der These der Angebotsinduzierung im stationären Sektor des deutschen Gesundheitswesens

This article tests the thesis of supply-induced demand in the German hospital sector. The empirical investigation described makes use of comprehensive data and represents the first time this has been done for Germany. A cross-section analysis is performed at the level of geographical planning regions. At this level the hospital date encompass the whole population and distinguish ten different medical specialities. 13 different economic and social variables are analysed in a system of simultaneous equations. The result shows that the supply of treatment capacity has a positive influence on the demand for hospital treatments, the number of patients treated per 100,000 population rising with bed density. Alternative explanations for this phenomenon are also checked, without result. No correlation can be found between morbidity and the number of hospital cases in any given region. Although hospital bed density is found to depend on the number of hospital cases per head of population, this is no proof of the reverse causality, as this result can be traced back to the strategy behind the existing hospital planning. The validity of Roemer's Law in Germany is likely to be (at least partially) due to this existing hospital planning. This is because the prevailing hospital planning procedure is distorted, inidcating a higher need for hospital beds where bed density is already high. Given this situation, and the results of the regression analysis, it would seem appropriate to consider abolishing the hospital planning system and radically reducing the density of hospital beds.