• Siegfried Geyer and Richard Peter.
• Medical Sociology Unit, Hannover Medical School. geyer.siegfried@mh-hannover.de
• Soz Praventivmed. 2003 Jan 1;48(2):105-14.

ObjectiveIt was examined whether the rate of hospital admissions change after transition into unemployment.MethodsData 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.ResultsThe 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).ConclusionFor 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.

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