Ripi - Regional inequality of health care in children

Principal Investigator:

Contact person:


BMBF (March 2012 to December 2014)

Current Status:

Recruitment and data collection are completed. Publications are in preparation. Qualification students welcome to participate in further analysis.

Ripi - Regional inequality of health care in children

Regional inequality of health care for chronically ill children: the effect of small area deprivation on outcomes in pediatric inflammatory bowel disease


Using a prospective cohort design, health care quality was examined in children with inflammatory bowel disease (IBD). The need for this study was derived from observations that children in certain regions of Germany have a delayed diagnosis as compared to other regions. We analyse potential determinants of quality of care on the individual (child, parents), regional (small area deprivation) and health care provider level. Vertical growth and quality of life are examined as the main outcomes. In addition, indicators of health care quality are analysed as intermediate outcome variables, e.g. structural and procedural aspects including patient satisfaction, costs, time to diagnosis, psychosocial development, schooling, disease activity and appropriate treatment of diagnosis. Participants were recruited from a paediatric clinical registry (CEDATA), the patient organisation DCCV e.V. and individual physicians. Postal questionnaires were used to survey children and parents, complemented by a four week cost diary. Follow up was at one year. Multilevel analysis is performed, including the use of a newly developed multidimensional social deprivation index. The study was performed at BIPS with Antje Timmer as principal investigator. Data are analysed in close collaboration with HMGU (Munich) and BIPS (Bremen).



  • Freckmann M, Peplies J, Stark R, Koletzko S, Kaltz B, Maier W, Timmer A. The effect of chronic disease on school performance - a survey in children with inflammatory bowel disease. HEC, München; August 8-September 2, 2016
  • Stark, Renee; Maier, Werner; Peplies, Jenny; Leidl, Rainer; Timmer, Antje (2015). Evaluation of medication costs of children with inflammatory bowel disease based on a cost diary. Jahrestagung der Deutschen Gesellschaft Gesundheitsökonomie DGGÖ. Bielefeld; March 16, 2015.
  • Peplies, Jenny; Bruns, Helena; Albers, Hannah Maike; Stark, Renee; Maier, Werner; Timmer, Antje (2012). Regionale Ungleichheit in der Gesundheitsversorgung chronisch kranker Kinder - Der Einfluss sozialer Deprivation auf die Prognose chronisch entzündlicher Darmerkrankungen. Auftaktveranstaltung zum Förderschwerpunkt "Studien in der Versorgungsforschung" des Bundesministeriums für Bildung und Forschung (BMBF). Berlin; October 8, 2012.
(Changed: 19 Dec 2022)