Hospital admissions after transition into unemployment.
OBJECTIVE
It was examined whether the rate of hospital admissions change after transition into unemployment.


METHODS
Data from a German statutory health insurance comprising 105,554 individuals (70.9% men, 29.1% women) with documented employment periods were used. Unemployment periods were divided into three intervals: up to eight months, more than eight up to 16, and more than 16 up to 24 months.


RESULTS
The overall "risks" of hospital admissions dropped after transition into unemployment. The relative risk (RR) in men and women for unemployment up to eight months was RR = 0.31 (95% CI: 0.28-0.34), for periods of more than eight up to 16 months it was RR = 0.35 (95% CI: 0.32-0.39) and for more than 16 up to 24 months it was RR = 0.27 (95% CI: 0.23-0.33). In contrast, for myocardial infarction they increased with length of unemployment: up to eight months: RR = 1.49 (95% CI: 1.04-2.13), more than eight up to 16 months; RR = 1.82 (95% CI: 1.21-2.74), more than 16 up to 24 months: RR = 3.08 (95% CI: 1.84-5.17).


CONCLUSIONS
For myocardial infarction the findings may reflect increased morbidity, for occupational diseases they may reflect a decrease following ceasing expositions at the workplace. For the remaining diagnostic groups decreasing health care utilisation may apply without morbidity having changed.
Geyer
Siegfried
S
Medical Sociology Unit, Hannover Medical School. geyer.siegfried@mh-hannover.de
Peter
Richard
R
D000328:Adult; D015984:Causality; D003430:Cross-Sectional Studies; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009203:Myocardial Infarction / Q000453:epidemiology; D009313:National Health Programs / Q000706:statistics & numerical data; D009784:Occupational Diseases / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D012306:Risk; D012737:Sex Factors; D012959:Socioeconomic Factors; D014478:Unemployment / Q000706:statistics & numerical data*