In 1995 a statutory nursing care insurance was set up in Germany. The MDK (Medical Service of Health Care Insurance Institutions) has been asked to evaluate the eligibility of the individual patients. Within a few months after this body began its work, strong regional differences in incidence became visible. A survey of 1995 MDK records from Bavarian counties was selected to determine whether and how sociodemographic or socioeconomic variables may explain these differences. An age incidence rate of nursing care, standardised according to age and sex, was correlated with a variety of explanatory factors. Only two variables in the multiple regression model were statistically significant: the refusal rate by local MDK officials and the regional supply of outpatient care facilities. Further work is needed to improve the process of evaluation and to minimise unexplained regional differences.

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