Kriwy P, Mielck A
Institut für Soziologie, Christian-Albrechts-Universität zu Kiel.
Gesundheitswesen. 2006 May;68(5):281-8. doi: 10.1055/s-2006-926779.
This paper deals with differences in health and health behaviour between those who are insured in the German Statutory Sickness Funds (GKV) and those who are privately insured (PKV). This topic has been largely ignored in German Public Health research. The analyses are based on data from a large survey in Germany conducted in 1998 and including 6822 adults. The multivariate analyses have been performed with OLS and logistic regression, separately for men and women and controlling for age, educational level, income and region. The most important result is that PKV-insured men have fewer diseases and feel more healthy than GKV-insured men. For women, though, no significant association could be found between health and type of health insurance. The interpretation of these results is mainly based on the "selection hypothesis", stating that healthier persons are more likely to be insured in the PKV than in the GKV. This would imply that the "causation hypothesis" (stating that being privately insured has a positive effect on health) is less important. Taking into account the current discussion on the balance between GKV and PKV, it is believed that future research should focus more on these topics.
本文探讨了德国法定医疗保险（GKV）参保者与私人医疗保险（PKV）参保者在健康状况和健康行为方面的差异。在德国公共卫生研究中，这一话题在很大程度上被忽视了。分析基于1998年在德国进行的一项大型调查数据，该调查涵盖了6822名成年人。多变量分析采用了OLS和逻辑回归，分别针对男性和女性，并控制了年龄、教育水平、收入和地区等因素。最重要的结果是，参保PKV的男性比参保GKV的男性疾病更少，感觉更健康。然而，对于女性而言，健康状况与医疗保险类型之间未发现显著关联。这些结果的解释主要基于“选择假设”，即健康状况较好的人比参保GKV的人更有可能参保PKV。这意味着“因果假设”（即参保私人医疗保险对健康有积极影响）的重要性较低。考虑到当前关于GKV和PKV平衡的讨论，人们认为未来的研究应更多地关注这些话题。
