Dinkel R H, Görtler E
Versicherungsmedizin. 1994 Feb 1;46(1):17-20.
In Germany different forms of insurance funds (private funds, social security for blue collar or for white collar workers, firm-specific funds) secure against sickness risks. Actual governmental policy is to increase the competition between funds by introducing the possibility to switch from one to the other. In order to compensate for the differences in risk of health status between individual members a compensation payment planned according to age and sex of the members. In 1974 a representative sample of the adult West German population has been asked about its sickness fund membership (among other questions). A new epidemiological concept, the demographic variant of the relative survival method, is used here to determine whether mortality in the 16 years after 1974 differed between the sickness fund members. Even after exact demographic control members of private sickness funds survived considerably better than members of other insurance funds. The highest mortality was found for members of the social security of blue collar workers (AOK). These results show that apart from the pure demographic factors other important health related differences exist between members of different sickness funds.
在德国,不同形式的保险基金(私人基金、蓝领或白领工人的社会保障、特定公司的基金)为疾病风险提供保障。目前的政府政策是通过引入从一种基金转换到另一种基金的可能性来增加基金之间的竞争。为了弥补个体成员健康状况风险的差异,根据成员的年龄和性别规划了一笔补偿金。1974年,对成年西德人口的一个代表性样本询问了其疾病基金会员资格(以及其他问题)。这里使用了一种新的流行病学概念,即相对生存方法的人口统计学变体,来确定1974年后的16年里,疾病基金成员的死亡率是否存在差异。即使经过精确的人口统计学控制,私人疾病基金的成员存活情况仍明显好于其他保险基金的成员。蓝领工人社会保障(AOK)的成员死亡率最高。这些结果表明,除了纯粹的人口统计学因素外,不同疾病基金的成员之间还存在其他与健康相关的重要差异。