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This paper provides an overview of cancer management, particularly with respect to colorectal cancer (CRC), in Germany. The information presented reflects findings from the peer-review literature and government documentation, as well as interviews with cancer and CRC specialists. Topics such as epidemiology, expenditure, CRC screening, pharmaceutical and non-pharmaceutical treatment are discussed in this paper. Furthermore, insights into the German reimbursement system with regard to cancer management as well as regulatory aspects are presented. [ABSTRACT FROM AUTHOR]

Background: Previous literature documents the direct and indirect economic costs of obesity, yet none has attempted to quantify the intangible costs of obesity. This study focuses on quantifying the intangible costs of one unit body mass index (BMI) increase and being overweight and obese in Germany. Methods: By applying a life satisfaction-based compensation value analysis to 2002–2018 German Socio-Economic Panel Survey data for adults aged 18–65, the intangible costs of overweight and obesity are estimated. We apply individual income as a reference for estimating the value of the loss of subjective well-being due to overweight and obesity. Results: The intangible costs of overweight and obesity in 2018 amount to 42,450 and 13,853 euros, respectively. A one unit increase in BMI induced a 2553 euros annual well-being loss in the overweight and obese relative to those of normal weight. When extrapolated to the entire country, this figure represents approximately 4.3 billion euros, an intangible cost of obesity similar in magnitude to the direct and indirect costs documented in other studies for Germany. These losses, our analysis reveals, have remained remarkably stable since 2002. Conclusions: Our results underscore how existing research into obesity's economic toll may underestimate its true costs, and they strongly imply that if obesity interventions took the intangible costs of obesity into account, the economic benefits would be considerably larger. [ABSTRACT FROM AUTHOR]

Abstract: This paper focuses on estimating the magnitude of any potential weight discrimination by examining whether obese job applicants in Germany get treated or behave differently from non-obese applicants. Based on two waves of rich survey data from the IZA Evaluation dataset, which includes measures that control for education, demographic characteristics, labor market history, psychological factors and health, we estimate differences in job search behavior and labor market outcomes between obese/overweight and normal weight individuals. Unlike other observational studies which are generally based on obese and non-obese individuals who might already be at different points in the job ladder (e.g., household surveys), in our data, individuals are newly unemployed and all start from the same point. The only subgroup we find in our data experiencing any possible form of negative labor market outcomes is obese women. Despite making more job applications and engaging more in job training programs, we find some indications that they experienced worse (or at best similar) employment outcomes than normal weight women. Obese women who found a job also had significantly lower wages than normal weight women. [Copyright &y& Elsevier]

We use German SHARE data to study the relationship between district general practitioner density and the quality of preventive care provided to older adults. We measure physician quality of care as the degree of adherence to medical guidelines (for the management of risk factors for cardiovascular disease and the prevention of falls) as reported by patients. Contrary to theoretical expectations, we find only weak and insignificant effects of physician density on quality of care. Our results shed doubt on the notion that increasing physician supply will increase the quality of care provided in Germany's present health care system. [ABSTRACT FROM AUTHOR]

Abstract: This paper examines the socio-economic variation in height and weight using data from the German Socio-Economic Panel. Results reinforce previous research insofar as height is associated with socio-economic differences. For example, a low maternal schooling level or a lower position in the income distribution is negatively correlated with the height of West Germans. Furthermore, there is a west–east and a north–south gradient in height in Germany. BMI is also determined by individuals’ characteristics with similar underlying patterns. That is, in both West and East Germany, women with low income and low education have a higher BMI whereas the better educated women weigh less. [Copyright &y& Elsevier]

We assess the impact of the timing of lockdown measures implemented in Germany and Switzerland on cumulative COVID-19-related hospitalization and death rates. Our analysis exploits the fact that the epidemic was more advanced in some regions than in others when certain lockdown measures came into force, based on measuring health outcomes relative to the region-specific start of the epidemic and comparing outcomes across regions with earlier and later start dates. When estimating the effect of the relative timing of measures, we control for regional characteristics and initial epidemic trends by linear regression (Germany and Switzerland), doubly robust estimation (Germany), or synthetic controls (Switzerland). We find for both countries that a relatively later exposure to the measures entails higher cumulative hospitalization and death rates on region-specific days after the outbreak of the epidemic, suggesting that an earlier imposition of measures is more effective than a later one. For Germany, we further evaluate curfews (as introduced in a subset of states) based on cross-regional variation. We do not find any effects of curfews on top of the federally imposed contact restriction that banned groups of more than 2 individuals. [ABSTRACT FROM AUTHOR]

We study the impact of school smoking bans on individual health behavior in Germany. Using a multiple difference-in-differences approach in combination with randomization inference, we find that for individuals affected by a smoking ban during their school time, the propensity toward smoking declines by 14–22 percent, while the number of smoked cigarettes per day decreases by 19–25 percent. After elaborating on treatment effect heterogeneity and intensity, we evaluate spillovers to smoking behavior of nontreated individuals living in the same household. [ABSTRACT FROM AUTHOR]

Due to regional competition and patient migration, the efficiency of healthcare provision at the regional level is subject to spatial dependence. We address this issue by applying a spatial autoregressive model to longitudinal data from Germany at the district ('Kreis') level. The empirical model is specified to explain efficiency scores, which we derive through non-parametric order-m efficiency analysis of regional health production. The focus is on the role of health policy of federal states ('Bundesländer') for district efficiency. Regression results reveal significant spatial spillover effects. Notably, accounting for spatial dependence does not decrease but increases the estimated effect of federal states on district efficiency. It appears that genuinely more efficient states are less affected by positive efficiency spillovers, so that taking into account spatial dependence clarifies the importance of health policy at the state level. [ABSTRACT FROM AUTHOR]

In this essay, I empirically analyze the relationship between income and life expectancy for pensioners in the public pension system in Germany and find that the relationship is non-monotonic for major sub-groups in the data. Due to the application of non-parametric methods, this cannot be explained as an artifact of the estimation technique or by anomalies of the data, and the finding is robust against the inclusion of control variables. Furthermore, I theoretically derive a non-monotonic relationship between income and longevity, based on heterogeneous elasticities of labor supply and otherwise standard assumptions. [ABSTRACT FROM AUTHOR]

We study the impact of new drug launches on early retirement due to disease and injury in the German labor force between 1988 and 2004. We show that new drug launches have substantially helped to reduce the loss of labor at the disease-level over time. In Western Germany alone, each new chemical entity is estimated to have saved on average around 200 working years in every year of the observation period. Controlling for individual determinants of retirement, the 2001 reform of pension laws appears to have led to further reductions in the loss of labor from disease and injury. [ABSTRACT FROM AUTHOR]

The positive association between moderate alcohol consumption and wages is well documented in the economic literature. Positive health effects as well as networking mechanisms serve as explanations for the “alcohol–income puzzle.” Using individual-based microdata from the SOEP for 2006, we confirm that this relationship exists for Germany as well. More importantly, we shed light on the alcohol–income puzzle by analyzing, for the first time, the association between beverage-specific drinking behavior and wages. In our analysis, we disentangle the general wage effect of drinking into diverse effects for different types of drinkers. Mincerian estimates reveal significant and positive relationships between wine drinkers and wages as well as between multiple beverage drinkers and wages. When splitting the sample into age groups, the “drinking gain” disappears for employees under the age of 35 and increases in size and significance for higher age groups. We also find a “beer gain” for the oldest age group and male residents of rural areas as well as a “cocktail gain” for residents of urban areas. Several explanations for our empirical results are discussed in view of the likelihood that the alcohol–income puzzle is a multicausal phenomenon. [ABSTRACT FROM AUTHOR]

The German health system represents the case of a global budget with negotiated fees and competing medical insurance companies. Physicians in private practice and non-profit dialysis provider associations provide most dialysis therapy. End-stage renal disease (ESRD) modalities are well integrated into the overall health care system. Dialysis therapy, independent of the mode of treatment, is reimbursed at a weekly flat rate. Mandatory health insurance covers health expenses, including those related to ESRD, for more than 90% of the population. Both employees and employers contribute to the premium for this insurance. Private medical insurance covers the remainder of the population. Access to treatment, including dialysis therapy, is uniformly available. [ABSTRACT FROM AUTHOR]