Background About 9 % of all children in Germany are born preterm. Despite significant improvements of medical care, preterm infants are at a greater risk to develop short and long term health complications. Negative consequences of preterm birth include neurodevelopmental disabilities, behavioral problems or learning disorders. Most data on effects of prematurity are derived from single or multi-center studies and not population-based. Since some of the long term problems of preterm delivery are associated with a disturbed parent-child interaction originating in the neonatal period, several intervention programs became available aiming to strengthen the early parent-child relationship. However, there is insufficient knowledge regarding the psychosocial and socioeconomic impact of these interventions. Prior to introducing them into routine care, those effects have to be rigorously evaluated. The population-based cohort study EcoCare-PIn (Early comprehensive Care of Preterm Infants—effects on quality of life, childhood development, and healthcare utilization) will investigate the following primary research questions: 1) What are the short- and long-term consequences of preterm birth with regard to parental stress, parent-child relationship, childhood development, quality of life and healthcare utilization including costs? 2) Does early family-centered psychosocial care prevent the hypothesized negative consequences of preterm birth on the above mentioned outcomes? Methods/Design EcoCare-PIn examines the research questions by means of a linkage of a) pseudonymized administrative individual-level claims data from the German statutory health insurance AOK PLUS on approximately 140,000 children born between 2007 and 2013 in Saxony, and b) primary data collected from the parents/caregivers of all very low birth weight (<1,500 g; n = 1,000) and low birth weight infants (1,500 to 2,500 g; n = 5,500) and a matched sample of infants above 2,500 g birth weight (n = 10,000). Discussion In Saxony, approximately 50 % of all individuals are insured at the AOK PLUS. The linkage of patient-level administrative and primary data is a novel approach in neonatal research and probably the only way to overcome shortcomings of studies solely relying on one data source. The study results are based on an observation period of up to 8 years and will directly inform perinatal healthcare provision in Saxony and Germany as a whole.

Background About 9 % of all children in Germany are born preterm. Despite significant improvements of medical care, preterm infants are at a greater risk to develop short and long term health complications. Negative consequences of preterm birth include neurodevelopmental disabilities, behavioral problems or learning disorders. Most data on effects of prematurity are derived from single or multi-center studies and not population-based. Since some of the long term problems of preterm delivery are associated with a disturbed parent-child interaction originating in the neonatal period, several intervention programs became available aiming to strengthen the early parent-child relationship. However, there is insufficient knowledge regarding the psychosocial and socioeconomic impact of these interventions. Prior to introducing them into routine care, those effects have to be rigorously evaluated. The population-based cohort study EcoCare-PIn (Early comprehensive Care of Preterm Infants—effects on quality of life, childhood development, and healthcare utilization) will investigate the following primary research questions: 1) What are the short- and long-term consequences of preterm birth with regard to parental stress, parent-child relationship, childhood development, quality of life and healthcare utilization including costs? 2) Does early family-centered psychosocial care prevent the hypothesized negative consequences of preterm birth on the above mentioned outcomes? Methods/Design EcoCare-PIn examines the research questions by means of a linkage of a) pseudonymized administrative individual-level claims data from the German statutory health insurance AOK PLUS on approximately 140,000 children born between 2007 and 2013 in Saxony, and b) primary data collected from the parents/caregivers of all very low birth weight (<1,500 g; n = 1,000) and low birth weight infants (1,500 to 2,500 g; n = 5,500) and a matched sample of infants above 2,500 g birth weight (n = 10,000). Discussion In Saxony, approximately 50 % of all individuals are insured at the AOK PLUS. The linkage of patient-level administrative and primary data is a novel approach in neonatal research and probably the only way to overcome shortcomings of studies solely relying on one data source. The study results are based on an observation period of up to 8 years and will directly inform perinatal healthcare provision in Saxony and Germany as a whole.

Im ersten Aufsatz dieser Dissertation analysiere ich, wie sich ein negativer Arbeitsmarktnachfrage-Schock auf Fertilität auswirkt. Ich analysiere dies anhand des ostdeutschen Fertilitätsrückgangs nach dem Mauerfall und nutze unerwartete, exogene, und permanente Anpassungen der Arbeitsnachfrage, welche von industriellen Restrukturierungsprozessen resultierten. Ostdeutsche Frauen, die stärker vom negativen Arbeitsnachfrage-Schock betroffen waren, haben in den 1990er Jahren relativ mehr Kinder bekommen als jene Frauen, die von dem Schock weniger stark betroffen waren. Der Schock hat somit nicht nur das aggregierte Fertilitätsniveau gesenkt, sondern auch die Zusammensetzung der Mütter beeinflusst. Der zweite Aufsatz untersucht den Einfluss staatlicher Hilfen auf den späteren ökonomischen Erfolg junger Flüchtlinge. Wir untersuchen dies anhand von ostdeutschen Flüchtlingen, die von 1946 bis 1961 nach Westdeutschland geflohen sind. Nur „politische Flüchtlinge“ hatten ab 1953 Anspruch auf Flüchtlingshilfen. Somit können wir Identifikations-Probleme adressieren, die durch Selektion entstehen. Es zeigen sich positive Effekte der Flüchtlingshilfen auf die Bildung, Jobs, und das Einkommen von Flüchtlingen, die als junge Erwachsene migriert sind. Wir finden keine vergleichbaren Effekte für Flüchtlinge, die als Kinder migriert sind. Das letzte Kapitel präsentiert Ergebnisse eines Projektes, das partiell die Lücke schließt, welche derzeit für Ostdeutsche in den deutschen Sozialversicherungsdaten existiert. Durch die Verknüpfung letzterer mit dem „Datenspeicher Gesellschaftliches Arbeitsvermögen“ der DDR von 1989 haben wir einen neuen Datensatz geschaffen, welcher Analysen von Phänomenen wie Arbeitslosigkeit, beruflicher und regionaler Mobilität ermöglicht. Der neue Datensatz kann auch dazu beitragen, das existierende Wissen über die individuellen Arbeitsmarktkonsequenzen des Mauerfalls zu erweitern. / In the first essay of this dissertation, I analyze how a negative labor demand shock impacts fertility. I analyze this question in the context of the East German fertility decline after the fall of the Berlin Wall in 1989. I exploit differential pressure for restructuring across East German industries which led to unexpected, exogenous, and permanent changes to labor demand. I find that throughout the 1990s, women more severely impacted by the demand shock had relatively more children than their less-severely-impacted counterparts. Thus, the demand shock not only depressed the aggregate fertility level, but also changed the composition of mothers. The second essay explores the question of how refugee-specific aid impacts the medium-term economic success of young refugees. We address this question in the context of German Democratic Republic (GDR) refugees who escaped to West Germany between 1946 and 1961, exploiting that only the subgroup of "political refugees" was granted refugee-targeted aid, and that this only occurred after 1953. The quasi-experiment allows us to address identification difficulties resulting from the fact that refugees eligible for aid are both self-selected and screened by local authorities. We find positive effects of aid-eligibility on educational attainment, job quality and income among the refugees who migrated as young adults. We do not find similar effects of aid-eligibility for refugees who migrated as children. The final chapter of this thesis presents results of a project which partially closes a gap that currently exists for East Germans in the German social security data. By linking these data with the GDR's "Data Fund of Societal Work Power" from 1989, we have created a new data set that permits the analysis of phenomena such as unemployment, job mobility, and regional mobility. The new data set can also be used to refine existing knowledge of the individual-level labor market consequences of German reunification.