[Statistical methods for research on regional health-care services]

Accurate modeling of spatial dependencies between observations is a significant challenge in research on regional health-care services. This article provides insight into current methods of modeling relationships in regional health-care service research, with consideration of spatial dependencies. Spatial dependencies may be triggered by spillover effects between neighboring regions and spatially distributed differences in - e.g., morbidity - which are not observable. If not considered in the model, the results of the analyses may be biased. Spatial dependencies can be added to the regression model as a spatial lag or a spatial error term. Using an example study, we illustrate that failing to consider spatial autocorrelation may lead to biased coefficients and/or standard errors. Research on regional health-care services should, therefore, if possible, test for spatial autocorrelation in the data and adjust the model accordingly.