The Influence of the Health System on Avoidable Deaths from Ischaemic Heart Diseases in East versus West Germany

The objectives of this paper are to identify the driving forces of health system performance in Germany as measured by the number of avoidable deaths from ischaemic heart diseases (IHD) and to assess the extent to which health authorities can influence health system performance. We find health authority effects to be significant, but relatively low in East as compared to West Germany. Further, decreases in West German mortality rates are explainable to a larger degree by observable factors of the health system than in East Germany. These results may explain why the massive modernization of the East German health system did not fully close the gap in avoidable deaths from IHD between East and West Germany and that factors, other than health system performance, may be accountable for this gap