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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.063339v1 96/9/1656    most recent Submit a response View responses Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Icks, A. Articles by Giani, G. Search for Related Content PubMed PubMed Citation Articles by Icks, A. Articles by Giani, G. Related Collections Diabetes Epidemiology Quality of Care Socioeconomic Factors Surveys

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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