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AJPH First Look, published online ahead of print Jul 27, 2006
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September 2006, Vol 96, No. 9 | American Journal of Public Health 1656-1661
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2005.063339

RESEARCH AND PRACTICE

Trends in Hospitalization and Sociodemographic Factors in Diabetic and Nondiabetic Populations in Germany: National Health Survey, 1990–1992 and 1998

Andrea Icks, MD, DrPH, Burkhard Haastert, PhD, Wolfgang Rathmann, MD, MSPH, Joachim Rosenbauer, MD and Guido Giani, PhD

The authors are with the German Diabetes Research Center, Institute of Biometrics and Epidemiology, Düsseldorf, Germany.

Correspondence: Request for reprints should be sent to Andrea Icks, MD, DrPH, German Diabetes Research Center, Institute of Biometrics and Epidemiology, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany (e-mail: icks{at}ddfi.uni-duesseldorf.de).

Objectives. We examined time trends of hospitalization, a main outcome measure in health care, in the diabetic and nondiabetic populations in Germany and their associations with sociodemographic variables.

Methods. Using data from 2 national health surveys, we estimated hospital days per person-year in the diabetic and nondiabetic populations in 1998 (n=5422) and 1990–1992 (n=7363) in Germany. We used Poisson regression to estimate relative risks and interaction of secular time with age, gender, and educational level, considering the cluster sample design of the study.

Results. Hospital days per person-year decreased between 1990–1992 and 1998—from 3.59 (95% confidence interval [CI]=2.59, 4.97) to 3.14 (95% CI=2.16, 4.56) for the diabetic population and from 1.38 (95% CI=1.23, 1.55) to 1.33 (95% CI=1.17, 1.51) for the nondiabetic population—but the decrease was not statistically significant. In the diabetic population, the decrease tended to be more pronounced (interaction year x time not significant; P=.756). Also, there was a notable decrease in men and in the group aged 25 to 39 years, and a decrease in both high- and low-educational-level subjects.

Conclusions. There seems to have been a larger decrease in hospitalization in the diabetic population than in the nondiabetic population in Germany. An increase in social disparity in this health outcome measure in the diabetic population could not be confirmed.




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AJPH Online, 18 Aug 2006 [Full text]

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