Health care utilisation and costs in the general population in Germany

• Average 6-month direct costs were €1305 in men and €1635 in women.
• Average 6-month indirect costs of full-time employees were €1327 (men) and €1806 (women).
• Disease prevalence was the most important predictor for costs.
• External validation showed sufficient representativeness.

AimTo elicit reference values of medical and non-medical health care utilisation and costs in Germany from a societal perspective.Methods5007 telephone interviews were conducted in a representative sample of the German-speaking population above the age of 18. Participants were asked about medical and non-medical health care utilisation over the preceding six months. Participants were also asked about medical conditions, lifestyle, sociodemographic characteristics, employment status and sick leave. Resource utilisation was valued monetarily and analysed by means of descriptive and econometric tools (generalised linear models/two-part models). To obtain representative results, we weighted observations according to age, gender, education and state of residence.Results95% of the respondents had at least one contact with an outpatient physician. 12% of the respondents were hospitalised and 3% received rehabilitative care. Direct costs per respondent were €1475 on average. The mean cost of physician visits was €278. We found differences in average costs for physician visits between men (€232) and women (€321). Indirect costs were €1554 on average per full-time employee. Multivariate analysis showed significant associations between direct costs and morbidity, age and gender. Indirect costs appeared to be significantly associated with morbidity and age, but not with gender.ConclusionOur reference values can be regarded as representative reference values for health care utilisation and costs, and can be used for the calculation of disease-specific excess costs.