Exploring regional differences in healthcare

From Aachen to Zwickau, the provision of appropriate medical care has to be guaranteed for the public throughout Germany. However, in many Healthcare Fact Check studies we have identified regional differences in care that can, at times, be quite significant. For example, in certain districts there are up to 13 times as many surgical interventions for back pain as in others. The differing rates of Caesarian sections have just as little medical basis: While in Dresden around 17 percent of babies are delivered by Caesarian section, in Landau in der Pfalz the rate is 51 percent. To investigate anomalies such as these, we are cooperating with the Science Media Center Germany (SMC), an initiative of the Klaus Tschira Foundation (Klaus Tschira Stiftung) and the German Science Journalists’ Association (Wissenschafts-Pressekonferenz e. V.).

The SMC uses the Operation Explorer research tool (see box), which highlights and compares the regional differences among Germany’s 402 administrative districts. We want regional journalists with interests in healthcare issues to be able to use this tool. In regularly scheduled workshops, journalists can learn how to conduct research using the database. The SMC also provides advice and support on location and assists in root cause analysis. Here, networks and the sharing of experience with other colleagues also play an important role. The objective is to have the results of research flow into well-founded reporting, so as to trigger changes in the regions that are statistical outliers.

The data-based internet program depicts regional differences in stationary care, as well as local patterns that are statistical outliers, for all of Germany’s districts and cities. In order to do this, Operation Explorer has collected over 150 million regionally coded hospital diagnoses and operations – currently from 2009 to 2015 and covering all age groups. The program, conceived primarily by and for journalists, comprises all available data on hospital statistics in one database application for the first time. An intuitive tool allows users to search the database and to analyze and directly visualize regional anomalies. Using Operation Explorer, researching journalists are, for the first time, also able to map the health policy landscape of Germany based on the best available statistical data. The tool provides reliable and regionally localized reference points for forming hypotheses as to why there are structures of medical overuse and underuse in Germany, and as to where one should look in detail for the root causes and responsible parties for these structures.