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).

Conclusion: 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.