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June 11, 2026Research in Health Services & RegionsOpen Access

Regional variation in healthcare utilization among patients with depression in Germany: a multilevel analysis with PopGrouper-based multimorbidity adjustment

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Authors

AKAnika KreutzbergCTChrissa TsatsaronisWQWilm Quentin

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Overview

Multilevel analysis reveals higher sickness absence in deprived regions among adults with depression, indicating access disparities.

Key Points

  • This analysis aims to explore how regional socioeconomic factors and urbanization relate to healthcare utilization for depression in Germany.
  • Analyzed claims data from a German sickness fund for 1,083,319 adults diagnosed with depression.
  • Utilized multilevel regression models accounting for age, sex, and multimorbidity with PopGrouper adjustment.
  • Classified regional socioeconomic deprivation and urbanization, measuring healthcare outcomes for 2023.
  • Higher socioeconomic deprivation correlates with increased sickness absence (34.1 days vs. 40.1 days).
  • Lower likelihood of outpatient psychotherapy in deprived areas (17.9% vs. 16.3%).
  • More frequent mental health specialist contacts in urban regions (15.6% vs. 13.5%).

Cite This Study

Kreutzberg et al. (2026) studied this question.

synapsesocial.com/papers/6a2a512e80c8f91e7f39d940https://doi.org/10.1007/s43999-026-00092-6
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The PopGrouper as a tool for morbidity adjustment in regional comparisons of health care: an analytical framework2025
  2. 2Depression treatment in Germany – using claims data to compare a collaborative mental health care program to the general practitioner program and usual care in terms of guideline adherence and need-oriented access to psychotherapy2020 · 8 citations
  3. 3Associations between neighbourhood characteristics and depression: a twin study2017 · 31 citations
  4. 4Mental and somatic comorbidity of depression: a comprehensive cross-sectional analysis of 202 diagnosis groups using German nationwide ambulatory claims data2020 · 209 citations
  5. 5Absenteeism and associated labour costs according to depressive symptom severity in the German general population: why preventive strategies matter2021 · 12 citations