Determinants of avoidable deaths from ischemic heart disease in East and West Germany

Abstract

Objective: Within Germany, a significant decrease in avoidable mortality from ischemic heart disease (IHD) has been observed since the early 1990s. The objective of this paper is to identify the specific reasons that have led to the decrease in the number of avoidable deaths from IHD in West and East Germany from 1996 to 2004. Methods: We analyzed the mortality rate from IHD of the male population aged less than 65 years on the regional level of German counties over the 1996–2004 period. Methodologically, after adjusting for a number of health structure variables, the socioeconomic structure of each region, and yearly time trends in avoidable mortality, we accounted for unobservable differences among regions by using a fixed-effect estimator. Results: Our main result reveals that the number of intracardiac catheter facilities, an important diagnostic tool for IHD, significantly accounts for decreases in avoidable mortality from IHD. This is important, as the modernization of the East German health sector included a considerable catching-up process in the number of IC facilities provided relative to West Germany. Conclusion: Our results suggest that the modernization of the East German health sector may have contributed to saving people from premature deaths.