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  1. Article: The socio-economic determinants of COVID-19: A spatial analysis of German county level data.

    Ehlert, Andree

    Socio-economic planning sciences

    2021  Volume 78, Page(s) 101083

    Abstract: The study explores the association of socioeconomic, demographic, and health-related variables at the regional level with COVID-19 related cases and deaths in Germany during the so-called first wave through mid-June 2020. Multivariate spatial models ... ...

    Abstract The study explores the association of socioeconomic, demographic, and health-related variables at the regional level with COVID-19 related cases and deaths in Germany during the so-called first wave through mid-June 2020. Multivariate spatial models include the 401 counties in Germany to account for regional interrelations and possible spillover effects. The case and death numbers are, for example, significantly positively associated with early cases from the beginning of the epidemic, the average age, the population density and the share of people employed in elderly care. By contrast, they are significantly negatively associated with the share of schoolchildren and children in day care as well as physician density. In addition, significant spillover effects on the case numbers of neighbouring regions were identified for certain variables, with a different sign than the overall effects, giving rise to further future analyses of the regional mechanisms of action of COVID-19 infection. The results complement the knowledge about COVID-19 infection beyond the clinical risk factors discussed so far by a socio-economic perspective at the ecological level.
    Language English
    Publishing date 2021-05-14
    Publishing country United States
    Document type Journal Article
    ISSN 0038-0121
    ISSN 0038-0121
    DOI 10.1016/j.seps.2021.101083
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  2. Article ; Online: The effects of health shocks on family status: do financial incentives encourage marriage?

    Ehlert, Andree

    The European journal of health economics : HEPAC : health economics in prevention and care

    2021  Volume 22, Issue 9, Page(s) 1393–1409

    Abstract: This paper asks whether marriage decisions of unmarried mature couples are driven by the prospect of financial advantages for the later widowed after one partner has suffered a serious health shock. We hypothesize that, in contrast to traditional ... ...

    Abstract This paper asks whether marriage decisions of unmarried mature couples are driven by the prospect of financial advantages for the later widowed after one partner has suffered a serious health shock. We hypothesize that, in contrast to traditional marriage models, such health shocks may induce unmarried couples to obtain economic benefits, such as survivors' pensions in particular, through marriage in advance of one partner's death. This question has not yet been studied empirically. Hazard models capturing unobserved effects are applied to longitudinal data of the German Socioeconomic Panel. It turns out that the probability of marriage after male partners' health shocks can increase significantly depending on the amount of expected survivors' pensions for the (likely) surviving female partners. In contrast, an increased probability of marriage after health shocks to women (depending on the expected financial benefits to men) was not found. These findings are supported by various robustness checks. Economic and political implications are discussed and the results are placed in an international context.
    MeSH term(s) Female ; Humans ; Male ; Marriage ; Motivation ; Pensions ; Socioeconomic Factors ; Survivors
    Language English
    Publishing date 2021-06-02
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2045253-6
    ISSN 1618-7601 ; 1618-7598
    ISSN (online) 1618-7601
    ISSN 1618-7598
    DOI 10.1007/s10198-021-01319-8
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  3. Article ; Online: The effects of health shocks on family status

    Ehlert, Andree

    do financial incentives encourage marriage?

    2021  

    Abstract: This paper asks whether marriage decisions of unmarried mature couples are driven by the prospect of financial advantages for the later widowed after one partner has suffered a serious health shock. We hypothesize that, in contrast to traditional ... ...

    Abstract This paper asks whether marriage decisions of unmarried mature couples are driven by the prospect of financial advantages for the later widowed after one partner has suffered a serious health shock. We hypothesize that, in contrast to traditional marriage models, such health shocks may induce unmarried couples to obtain economic benefits, such as survivors’ pensions in particular, through marriage in advance of one partner’s death. This question has not yet been studied empirically. Hazard models capturing unobserved effects are applied to longitudinal data of the German Socioeconomic Panel. It turns out that the probability of marriage after male partners’ health shocks can increase significantly depending on the amount of expected survivors’ pensions for the (likely) surviving female partners. In contrast, an increased probability of marriage after health shocks to women (depending on the expected financial benefits to men) was not found. These findings are supported by various robustness checks. Economic and political implications are discussed and the results are placed in an international context.
    Keywords ddc:610 ; C40 ; D10 ; H55 ; I10 ; Health shock ; Marriage ; Survivor’s pension ; Widow ; Old-age poverty ; Unobserved heterogeneity ; Frailty ; Hazard model ; SOEP ; Germany
    Language English
    Publisher Berlin, Heidelberg: Springer
    Publishing country de
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: German physicians' expectations of healthcare management companies: An exploratory study.

    Oberschachtsiek, Dirk / Ehlert, Andree

    Health science reports

    2022  Volume 5, Issue 6, Page(s) e866

    Abstract: Background and aims: Even 20 years after the introduction of managed care (MC) in Germany, many physicians are skeptical of the concept, hindering its acceptance.: Methods: Based on multivariate statistical methods this exploratory study examines how ...

    Abstract Background and aims: Even 20 years after the introduction of managed care (MC) in Germany, many physicians are skeptical of the concept, hindering its acceptance.
    Methods: Based on multivariate statistical methods this exploratory study examines how so-called management companies, that is, administrative service providers within MC contracts, can increase physicians' acceptance of MC by offering, for example, day-to-day coordination and administrative tasks.
    Results: As a main empirical result, we find support for this hypothesis, that is, that certain physicians evaluate their MC participation according to its prospective administrative support. Based on this, up to four clusters of physicians can be statistically identified in terms of their preferences regarding MC.
    Conclusion: As a policy recommendation, we derive from our results that a future focus on the administrative support components of MC is essential to attract certain physician groups to participate in MC.
    Language English
    Publishing date 2022-10-29
    Publishing country United States
    Document type Journal Article
    ISSN 2398-8835
    ISSN (online) 2398-8835
    DOI 10.1002/hsr2.866
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  5. Article: [No title information]

    Ehlert, Andree

    Gesundheitsökonomie & Qualitätsmanagement

    2017  Volume 22, Issue 06, Page(s) 290–296

    Abstract: Ziel: Die Studie analysiert aufgabenbezogene Kooperationen niedergelassener Ärzte wie u. a. Versorgungsprogramme, Fachnetzwerke, Qualitätszirkel oder Fallkonferenzen. Ein multivariates statistisches Modell quantifiziert mögliche ...

    Abstract Ziel: Die Studie analysiert aufgabenbezogene Kooperationen niedergelassener Ärzte wie u. a. Versorgungsprogramme, Fachnetzwerke, Qualitätszirkel oder Fallkonferenzen. Ein multivariates statistisches Modell quantifiziert mögliche Einflussfaktoren auf spezifische Kooperationsformen. Dadurch können Anhaltspunkte für das Zustandekommen ärztlicher Kooperationen identifiziert werden.
    Methodik: Im August und September 2014 wurden in einer Zufallsstichprobe 6 000 niedergelassener Ärzte (im Folgenden immer m/w) aus den Bundesländern Bremen, Hamburg, Niedersachsen und Schleswig-Holstein 504 voll strukturierte Telefoninterviews auf Basis eines neu entwickelten Fragebogens durchgeführt.
    Ergebnisse: Mehr als die Hälfte der befragten Ärzte ist in Qualitätszirkel, Fallkonferenzen oder Fachnetze eingebunden. Die Kooperationsneigung älterer Praxisinhaber ist geringer. Signifikante Stadt-Land-Unterschiede existieren im Allgemeinen nicht. Die Anzahl der in der Praxis tätigen Ärzte hat generell keinen Einfluss auf das Kooperationsniveau, während die Mitarbeit in Verbänden einen positiven Einfluss hat.
    Schlussfolgerung: Die Beteiligung an aufgabenbezogenen Kooperationsformen zeigt, dass der ambulante Sektor weniger zersplittert ist als oft angenommen. Der Einfluss spezifischer Praxismerkmale auf Kooperationen liefert systematische Ansatzpunkte für politische Maßnahmen. Es lassen sich u. a. altersspezifische Ansprachen der Ärzte sowie Forschungsbedarf über die Rolle der Berufsverbände ableiten.
    Keywords Kooperation ; Integrierte Versorgung ; Ärztebefragung ; Deutschland ; Managed Care ; Cooperation ; integrated care ; physician survey ; Germany ; managed care
    Language German
    Publishing date 2017-03-06
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2072461-5
    ISSN 1439-4049 ; 1432-2625
    ISSN (online) 1439-4049
    ISSN 1432-2625
    DOI 10.1055/s-0043-103023
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  6. Article ; Online: Can telehealth reduce health care expenditure? A lesson from German health insurance data.

    Ehlert, Andree / Oberschachtsiek, Dirk

    The International journal of health planning and management

    2019  Volume 34, Issue 4, Page(s) 1121–1132

    Abstract: This study analyzes a telemedical program for chronic heart failure in Germany with respect to economic and treatment indicators. The program entails a routine data-based preselection of the insured and specific treatment intensities for low- and high- ... ...

    Abstract This study analyzes a telemedical program for chronic heart failure in Germany with respect to economic and treatment indicators. The program entails a routine data-based preselection of the insured and specific treatment intensities for low- and high-risk patients. This study complements previous research by considering differentiated end points such as mortality and rehospitalization as well as ambulatory, outpatient, and medication costs to account for potential cost shifts. In addition, different time frames and regional characteristics are dealt with. A difference-in-differences approach accounts for potential self-selection into the voluntary program. Our results challenge the current paradigm of program-induced cost shifting between hospital and ambulatory care. Except for a short-term effect in the lower-risk group, the program is associated with raising hospital admission rates as well as higher costs in all categories, while mortality is significantly reduced. The findings are robust as to various sensitivity checks.
    MeSH term(s) Aged ; Cost Savings/economics ; Cost Savings/statistics & numerical data ; Female ; Germany ; Health Expenditures/statistics & numerical data ; Heart Failure/economics ; Heart Failure/therapy ; Humans ; Insurance, Health/economics ; Insurance, Health/statistics & numerical data ; Male ; Telemedicine/economics
    Language English
    Publishing date 2019-03-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 632786-2
    ISSN 1099-1751 ; 0749-6753
    ISSN (online) 1099-1751
    ISSN 0749-6753
    DOI 10.1002/hpm.2764
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  7. Article ; Online: Why do German physicians reject managed care?

    Ehlert, Andree / Oberschachtsiek, Dirk

    The International journal of health planning and management

    2018  Volume 34, Issue 1, Page(s) 87–99

    Abstract: Background: Approximately 20 years after the launch of managed care (MC) in Germany, the initial dynamics have turned into an MC backlash with a poor image for MC among physicians and the insured. Factors in MC contract rejection by physicians have not ... ...

    Abstract Background: Approximately 20 years after the launch of managed care (MC) in Germany, the initial dynamics have turned into an MC backlash with a poor image for MC among physicians and the insured. Factors in MC contract rejection by physicians have not previously been studied systematically.
    Objective: The objective of the study is to show that observed physician characteristics explain MC contract rejection in a quantitative model. These econometric findings will be related to suitable political measures to foster physicians' MC acceptance.
    Methods: Results are based on 500 completed responses to a survey among practicing physicians in Northern Germany. Physician cooperation, attitudes toward MC, and practice characteristics are addressed. A Heckman approach accounts for potential preselection of physicians by insurers. Econometric findings are complemented by a qualitative analysis of free-text answers.
    Results: Private patient share, physician age, and number of physicians per practice significantly increase rejection probability, whereas it is decreased by rural location. Qualitatively, administrative burden and loss of professional autonomy are the main reasons for MC refusal.
    Conclusion: Current health policy focuses on institutional measures such as innovation funding to promote MC. Our results show that it may be more effective to turn attention to practicing physicians' preferences as a bottleneck to MC development.
    MeSH term(s) Attitude of Health Personnel ; Germany ; Humans ; Interviews as Topic ; Managed Care Programs ; Middle Aged ; Models, Econometric ; Physicians/psychology ; Professional Autonomy ; Qualitative Research ; Surveys and Questionnaires
    Language English
    Publishing date 2018-08-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 632786-2
    ISSN 1099-1751 ; 0749-6753
    ISSN (online) 1099-1751
    ISSN 0749-6753
    DOI 10.1002/hpm.2575
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  8. Book ; Article ; Online: The role of COVID-19 in spatial reorganization

    Ehlert, Andree / Wedemeier, Jan / Zahlmann, Tabea

    Some evidence from Germany

    2021  

    Abstract: This paper analyzes the role of regional demographic, socioeconomic and political factors on changes in mobility during the COVID-19 pandemic. It provides new empirical evidence for the regional differentiation of lockdown measures and indicates a ... ...

    Abstract This paper analyzes the role of regional demographic, socioeconomic and political factors on changes in mobility during the COVID-19 pandemic. It provides new empirical evidence for the regional differentiation of lockdown measures and indicates a possible reorganization of spatial economic and social activities beyond the course of the pandemic. Spatial econometric models are analyzed using data from the 401 counties in Germany. Our results show that, for example, current high caseloads are negatively related to changes in mobility, whereas a region's socioeconomic composition and rural location have a positive effect. The political and economic implications of the findings are discussed.
    Keywords ddc:330 ; R10 ; R11 ; R12 ; economic geography ; COVID-19 pandemic ; lockdown ; regional interaction ; mobility ; spatial econometrics
    Language English
    Publisher Hamburg: Hamburgisches WeltWirtschaftsInstitut (HWWI)
    Publishing country de
    Document type Book ; Article ; Online
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  9. Article: Trouble on my mind: the effect of catastrophic events on people's worries

    Ehlert, Andree / Seidel, Jan / Weisenfeld-Schenk, Ursula

    Seidel : Jan , p. 41-75

    2017  , Page(s) 41–75

    Author's details Andree Ehlert, Jan Seidel, and Ursula Weisenfeld
    Keywords Finanzkrise ; Kernkraftwerk ; Störfall ; Katastrophe ; Wahrnehmung ; Wirkungsanalyse ; Angst ; Spillover-Effekt ; Verdrängungseffekt ; Schätzung ; Deutschland ; Terrorismus
    Language English
    Publishing place Lüneburg
    Document type Article
    Database ECONomics Information System

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  10. Article: Overcoming resistance against managed care - insights from a bargaining model.

    Ehlert, Andree / Wein, Thomas / Zweifel, Peter

    Health economics review

    2017  Volume 7, Issue 1, Page(s) 19

    Abstract: Recent healthcare reforms have sought to increase efficiency by introducing managed care (MC) while respecting consumer preferences by admitting choice between MC and conventional care. This article proposes an institutional change designed to let German ...

    Abstract Recent healthcare reforms have sought to increase efficiency by introducing managed care (MC) while respecting consumer preferences by admitting choice between MC and conventional care. This article proposes an institutional change designed to let German consumers choose between the two settings through directing payments from the Federal Health Fund to social health insurers (SHIs) or to specialized MC organizations (MCOs). To gauge the chance of success of this reform, a game involving a SHI, a MCO, and a representative insured (RI) is analyzed. In a "three-player/three-cake" game the coalitions {SHI, MCO}, {MCO, RI}, and {SHI, RI} can form. Players' possibility to switch between coalitions creates new outside options, causing the conventional bilateral Nash bargaining solution to be replaced by the so-called von Neumann-Morgenstern triple. These triples are compared to the status quo (where the RI has no threat potential) and related to institutional conditions characterizing Germany, the Netherlands, and Switzerland.
    Language English
    Publishing date 2017-05-22
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2634483-X
    ISSN 2191-1991
    ISSN 2191-1991
    DOI 10.1186/s13561-017-0156-4
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