Trends in hospitalization and sociodemographic factors in diabetic and nondiabetic populations in Germany: National Health Survey, 1990-1992 and 1998

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. doi:10.2105/AJ PH. 2005.063339