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Utilisation of rehabilitation services for non-migrant and migrant groups of higher working age in Germany – results of the lidA cohort study

BACKGROUND: An ageing and a shrinking labour force implies that the prevention of a premature exit from work due to poor health will become more relevant in the future. Medical rehabilitation is a health service that aims at active participation in working life. The provision of this service will be...

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Autores principales: Schröder, Chloé Charlotte, Dyck, Maria, Breckenkamp, Jürgen, Hasselhorn, Hans Martin, du Prel, Jean-Baptist
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954536/
https://www.ncbi.nlm.nih.gov/pubmed/31924217
http://dx.doi.org/10.1186/s12913-019-4845-z
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author Schröder, Chloé Charlotte
Dyck, Maria
Breckenkamp, Jürgen
Hasselhorn, Hans Martin
du Prel, Jean-Baptist
author_facet Schröder, Chloé Charlotte
Dyck, Maria
Breckenkamp, Jürgen
Hasselhorn, Hans Martin
du Prel, Jean-Baptist
author_sort Schröder, Chloé Charlotte
collection PubMed
description BACKGROUND: An ageing and a shrinking labour force implies that the prevention of a premature exit from work due to poor health will become more relevant in the future. Medical rehabilitation is a health service that aims at active participation in working life. The provision of this service will be relevant for an increasing part of the ageing labour force, namely, employees with a migrant background and their different subgroups. Thus, this study examines whether first- and second-generation employees with migrant background differ from non-migrants in their utilisation of rehabilitation services and whether within the subsample of migrant employees, those persons with foreign nationality differ from those with German nationality. METHODS: Socially insured employees born in 1959 or 1965 were surveyed nationwide in 2011 as part of the lidA cohort study (n=6303). Survey data of the first study wave were used to identify the dependent variable of the utilisation of rehabilitation (in- and outpatient), the independent variable of migrant status and the covariates of sociodemographic, work- and non-work-related factors. Applying bivariate statistics with tests of independence and block-wise logistic regressions, differences between the groups were investigated. Additionally, average marginal effects were computed to directly compare the adjusted models. RESULTS: The study showed that first-generation migrants had a significantly lower likelihood of utilising outpatient rehabilitation than non-migrants (fully adj. OR 0.42, 95% CI 0.22-0.82) and that average marginal effects indicated higher differences in the full model than in the null model. No significant differences were found between the first- or second-generation migrants and non-migrants when comparing the utilisation of inpatient rehabilitation or any rehabilitation or when analysing German and foreign employees with migrant background (n=1148). CONCLUSIONS: Significant differences in the utilisation of outpatient rehabilitation between first-generation migrants and non-migrants were found, which could not be explained by sociodemographic, work- and non-work-related factors. Thus, further factors might play a role. The second-generation migrants resemble the non-migrants rather than their parent generation (first-generation migrants). This detailed investigation shows the heterogeneity in the utilisation of health services such as medical rehabilitation, which is why service sensitive to diversity should be considered.
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spelling pubmed-69545362020-01-14 Utilisation of rehabilitation services for non-migrant and migrant groups of higher working age in Germany – results of the lidA cohort study Schröder, Chloé Charlotte Dyck, Maria Breckenkamp, Jürgen Hasselhorn, Hans Martin du Prel, Jean-Baptist BMC Health Serv Res Research Article BACKGROUND: An ageing and a shrinking labour force implies that the prevention of a premature exit from work due to poor health will become more relevant in the future. Medical rehabilitation is a health service that aims at active participation in working life. The provision of this service will be relevant for an increasing part of the ageing labour force, namely, employees with a migrant background and their different subgroups. Thus, this study examines whether first- and second-generation employees with migrant background differ from non-migrants in their utilisation of rehabilitation services and whether within the subsample of migrant employees, those persons with foreign nationality differ from those with German nationality. METHODS: Socially insured employees born in 1959 or 1965 were surveyed nationwide in 2011 as part of the lidA cohort study (n=6303). Survey data of the first study wave were used to identify the dependent variable of the utilisation of rehabilitation (in- and outpatient), the independent variable of migrant status and the covariates of sociodemographic, work- and non-work-related factors. Applying bivariate statistics with tests of independence and block-wise logistic regressions, differences between the groups were investigated. Additionally, average marginal effects were computed to directly compare the adjusted models. RESULTS: The study showed that first-generation migrants had a significantly lower likelihood of utilising outpatient rehabilitation than non-migrants (fully adj. OR 0.42, 95% CI 0.22-0.82) and that average marginal effects indicated higher differences in the full model than in the null model. No significant differences were found between the first- or second-generation migrants and non-migrants when comparing the utilisation of inpatient rehabilitation or any rehabilitation or when analysing German and foreign employees with migrant background (n=1148). CONCLUSIONS: Significant differences in the utilisation of outpatient rehabilitation between first-generation migrants and non-migrants were found, which could not be explained by sociodemographic, work- and non-work-related factors. Thus, further factors might play a role. The second-generation migrants resemble the non-migrants rather than their parent generation (first-generation migrants). This detailed investigation shows the heterogeneity in the utilisation of health services such as medical rehabilitation, which is why service sensitive to diversity should be considered. BioMed Central 2020-01-10 /pmc/articles/PMC6954536/ /pubmed/31924217 http://dx.doi.org/10.1186/s12913-019-4845-z Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Schröder, Chloé Charlotte
Dyck, Maria
Breckenkamp, Jürgen
Hasselhorn, Hans Martin
du Prel, Jean-Baptist
Utilisation of rehabilitation services for non-migrant and migrant groups of higher working age in Germany – results of the lidA cohort study
title Utilisation of rehabilitation services for non-migrant and migrant groups of higher working age in Germany – results of the lidA cohort study
title_full Utilisation of rehabilitation services for non-migrant and migrant groups of higher working age in Germany – results of the lidA cohort study
title_fullStr Utilisation of rehabilitation services for non-migrant and migrant groups of higher working age in Germany – results of the lidA cohort study
title_full_unstemmed Utilisation of rehabilitation services for non-migrant and migrant groups of higher working age in Germany – results of the lidA cohort study
title_short Utilisation of rehabilitation services for non-migrant and migrant groups of higher working age in Germany – results of the lidA cohort study
title_sort utilisation of rehabilitation services for non-migrant and migrant groups of higher working age in germany – results of the lida cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954536/
https://www.ncbi.nlm.nih.gov/pubmed/31924217
http://dx.doi.org/10.1186/s12913-019-4845-z
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