Regional variation in healthcare utilization among patients with depression in Germany: a multilevel…

Cohort studyResearch in health services & regions· Jun 2026

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

Anika Kreutzberg, Chrissa Tsatsaronis, Wilm Quentin … PopGroup consortium

Multimorbidity & PolypharmacyCohort study

Depression patients in deprived regions had more sickness-absence days than in least-deprived regions.

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

Anika Kreutzberg … PopGroup consortium

Research in health services & regions · Jun 2026

Background

Depression is associated with a substantial health and economic burden and shows pronounced regional variation in Germany.

Methods

We analyzed nationwide claims data from a large German sickness fund including adults with diagnosed depression (N = 1,083,319).

n = 1,083,319

Results

sickness absence rose in more deprived regions

Least deprived

34.1days

Most deprived

40.1days

More results

No significant associations were observed between deprivation and healthcare costs or mental health specialist contacts.

Overall regional clustering was modest but most pronounced for mental health specialist contacts.

“

Conclusion

Regional socioeconomic deprivation is linked to higher sickness absence due to depression. Regional inequalities in access to mental health services are small but largely unexplained by deprivation, urbanization, and multimorbidity.

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

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

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