[Income, health, and health services utilization in Germany 1992]

Data from the 1992 wave of the Socioeconomic Panel were used to analyse the relation between incomes, need for and utilisation of health care in East- and West Germany employing methods coming from the economic measurement of income distributions. "Self assessed health" and "restricted activities of daily living" were employed as need indicators. Utilisation was measured by the number of "visits to physicians" and "days in hospital". Data was available for 6435 individuals (west) and 3928 individuals (east). Income was defined as equivalent net household income with an equivalence scale derived from the german social assistance program. Compared to the concentration of income all variables in the scope of this study were only marginally concentrated (i.e. equally distributed). A slight concentration of need amongst the lower income was overcompensated by utilisation. Thus a very small impact of the German health care system favouring lower income individuals was measured. The study shows methodological problems when combining data from regions with strongly different income levels instead of analysing them separately. A combined analysis tends to underestimate concentration.