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

Brzoska P, Voigtländer S, Spallek J, Razum O (2010)
European Journal of Epidemiology 25(9): 651-660.

Journal Article | Published | English

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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, socio-economic 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.
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Brzoska P, Voigtländer S, Spallek J, Razum O. Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany. European Journal of Epidemiology. 2010;25(9):651-660.
Brzoska, P., Voigtländer, S., Spallek, J., & Razum, O. (2010). Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany. European Journal of Epidemiology, 25(9), 651-660.
Brzoska, P., Voigtländer, S., Spallek, J., and Razum, O. (2010). Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany. European Journal of Epidemiology 25, 651-660.
Brzoska, P., et al., 2010. Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany. European Journal of Epidemiology, 25(9), p 651-660.
P. Brzoska, et al., “Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany”, European Journal of Epidemiology, vol. 25, 2010, pp. 651-660.
Brzoska, P., Voigtländer, S., Spallek, J., Razum, O.: Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany. European Journal of Epidemiology. 25, 651-660 (2010).
Brzoska, Patrick, Voigtländer, Sven, Spallek, Jacob, and Razum, Oliver. “Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany”. European Journal of Epidemiology 25.9 (2010): 651-660.
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7 Citations in Europe PMC

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[Accessibility and quality of rehabilitative services among migrants in Germany].
Brzoska P, Razum O., Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 58(6), 2015
PMID: 25861042
[Prevention among migrants: Participation, migrant sensitive strategies and programme characteristics].
Brand T, Kleer D, Samkange-Zeeb F, Zeeb H., Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 58(6), 2015
PMID: 25861044
Reviewing the topic of migration and health as a new national health target for Germany.
Brzoska P, Ellert U, Kimil A, Razum O, Sass AC, Salman R, Zeeb H., Int J Public Health 60(1), 2015
PMID: 25387986
Lower frequency of insulin pump treatment in children and adolescents of Turkish background with type 1 diabetes: analysis of 21,497 patients in Germany.
Icks A, Razum O, Rosenbauer J, Bachle C, Hungele A, Monkemoller K, Muller-Godeffroy E, Heidtmann B, Kapellen T, Scheuing N, Holl RW., Diabetes Technol. Ther. 14(12), 2012
PMID: 23216338
[The care of people with a migration background in psychosomatic rehabilitation].
Mosko MO, Pradel S, Schulz H., Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 54(4), 2011
PMID: 21465403

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