Do persons that changed health insurance differ from those who did not? The case of diabetes.

AIMS: We aimed to compare German adults that changed health insurance since 1996 with those who did not with special emphasis on diabetes.
METHODS: 8 representative surveys (conducted 2005-2008) of the 'Bertelsmann Healthcare Monitor' comprising 12,362 participants aged 18-79 years were analysed. We compared participants that changed their health insurance fund with those who did not. To study if diabetes is associated with switching, we fitted logistic regression models and stepwise adjusted for age, sex, cardiovascular comorbidities, anthropometric measures and health-related factors.
RESULTS: About one third (32.0%) changed their health insurance fund since 1996. Compared to persons that did not change, those who did were younger, higher educated, assessed their health status better and had less cardiovascular diseases. The prevalence of diabetes was much lower in persons that changed their fund than in those who did not (3.6% vs. 8.9%; Odds Ratio [OR]: 0.38; 95% confidence interval [CI]: 0.31-0.47). Adjusting for age and sex leads to a non-significant OR of 0.81 (95% CI: 0.64-1.02), which remained in the fully adjusted model (OR: 0.88; 95% CI: 0.69-1.12).
CONCLUSIONS: Persons that changed their fund had a much lower prevalence of diabetes than those who did not. Most of this difference could be explained by age. We found quite similar figures for hypertension, a more prevalent disease. However, ORs were significant in all described models, probably due to a higher statistical power. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.