Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany

Abstract

In Germany, the proportion of foreign national residents receiving an invalidity pension is higher than that of Germans. Lower utilization and effectiveness of medical rehabilitation are presumed to be the main reasons. We aimed to examine whether differences in utilization and effectiveness of medical rehabilitation between Germans and foreign nationals are attributable to differences in socio-demography, socioeconomic background and health status. Utilization of rehabilitation was analyzed for household members aged 18 years or above enrolled in the German Socio-Economic Panel in 2002-2004 (n=19,521). Effectiveness of rehabilitation was defined by the occupational performance at the end of rehabilitation. It was examined by using an 80% random sample of all completed medical rehabilitations in the year 2006 funded by the German Statutory Pension Insurance Scheme (n=634,529). Our study shows that foreign nationals utilize medical rehabilitation less often than Germans (OR=0.68; 95%-CI=0.50;0.91). For those who do, medical rehabilitation is less effective (OR for low occupational performance=1.50; 95%-CI=1.46;1.55). Both findings are only partially attributable to socio-demographic, socio-economic and health characteristics: After adjusting for these factors, ORs for utilization and low occupational performance were 0.66 (95%-CI=0.49;0.90) and 1.20 (95%-CI=1.16;1.24), respectively. It can be concluded that differences in the utilization and effectiveness of medical rehabilitation between Germans and foreign nationals cannot be explained only by socio-economic differences or poorer health before rehabilitation. In addition, factors such as the ability of the rehabilitative care system to accommodate clients with differing expectations, and migrant-specific characteristics such as cultural differences, seem to play a role.3

Die gesundheitliche Lage von Menschen mit Migrationshintergrund und die Bedeutung des sozioökonomischen Status

“…So gibt es Hinweise darauf, dass Menschen mit Migrationshintergrund ihren Gesundheitszustand subjektiv schlechter bewerten und auch die psychische Gesundheit in der Bevöl-kerung ohne Migrationshintergrund besser ist [4,[9][10][11]. Zudem nehmen Menschen mit Migrationshintergrund manche Gesundheitsleistungen seltener in Anspruch [12][13][14][15].…”

Die Versorgung von Menschen mit Migrationshintergrund in der psychosomatischen Rehabilitation

“…Die aktuelle Inanspruchnahme medizinischer Rehabilitationsmaßnahmen durch Menschen mit Migrationshintergrund ist demgegenüber allerdings geringer [15,16,17] als bei der deutschen Bevölkerung.…”

“…Diese Ergebnisse zur mangelnden Inanspruchnahme decken sich mit anderen Befunden aus der medizinischen Rehabilitation [16,17] aber auch aus der ambulanten psychotherapeutischen Versorgung [36]. Angesichts eines erhöhten Gesundheitsrisikos [2] und einer erhöh-ten psychosozialen Belastung von Menschen mit Migrationshintergrund erhält diese geringere Inanspruchnahme eines fachgerechten Behandlungsangebotes ein noch stärkeres Gewicht.…”

Lower Frequency of Insulin Pump Treatment in Children and Adolescents of Turkish Background with Type 1 Diabetes: Analysis of 21,497 Patients in Germany

“…[1][2][3][4] In Germany in particular, people with Turkish background, the largest ethnic minority, have been found to have poor health outcomes. [5][6][7] As possible reasons for lower acceptance of prevention and treatment offers, language barriers, lower socioeconomic status, another disease belief, or, on the other hand, factors within the healthcare system have been discussed. 5 However, little is known regarding differences in diabetes care processes between pediatric diabetes patients with and without Turkish migration background.…”