Self-rated treatment outcomes in medical rehabilitation among German and non-German nationals residing in Germany: an exploratory cross-sectional study.

P Brzoska,O Sauzet,Y Yilmaz-Aslan,T Widera,O Razum

doi:10.1186/s12913-016-1348-z

Abstract

BackgroundIn many European countries, foreign nationals experience, on average, less favorable treatment outcomes in rehabilitative care than the respective majority population. In Germany, this for example is reflected in a lower occupational performance and a higher risk of disability retirement after rehabilitation as analyses of routine data show. However, little is known about the perspective of health care users. The aim of the present study was to compare self-rated treatment outcomes between German and non-German nationals undergoing in-patient medical rehabilitation in Germany.MethodsWe analyzed data from a cross-sectional representative rehabilitation patient survey of 239,811 patients from 642 clinics in Germany who completed about 3 weeks of in-patient rehabilitative treatment. The self-rating of the treatment outcome was based on a dichotomized Likert scale consisting of three items. A multilevel logistic regression analysis adjusted for various demographic, socio-economic, health and other covariates was conducted to examine differences in the self-rated treatment outcome between German and non-German nationals.ResultsOf the 239,811 respondents 0.9 % were nationals from Turkey, 0.8 % had a nationality from a former Yugoslavian country, 0.9 % held a nationality from the South European countries Portugal, Spain, Italy or Greece and 1.9 % were nationals from other countries. Non-German nationals reported a less favorable self-rated outcome than Germans. Adjusted odds ratios [OR] for reporting a less favorable treatment outcome were 1.24 (95 %-confidence interval [95 %-CI]: 1.12–1.37) for nationals from the South European countries Portugal/Spain/Italy/Greece, 1.62 (95 %-CI: 1.45–1.80) for Turkish nationals and 1.68 (95 %-CI: 1.52–1.85) for nationals from Former Yugoslavia.ConclusionsKnowledge on health outcomes from the patients’ point of view is important for the provision of patient-centered health care. Our study showed that non-German nationals report less favorable outcomes of rehabilitative care than Germans. This may be due to cultural and religious needs not sufficiently addressed by health care providers. In order to improve rehabilitative care for non-German nationals, rehabilitative services must become sensitive to the needs of this population group. Diversity management can contribute to this process.

Highlights

In many European countries, foreign nationals experience, on average, less favorable treatment outcomes in rehabilitative care than the respective majority population
Differences become evident with respect to underlying diseases conditions, with larger proportions of non-Germans compared to Germans, for instance, undergoing rehabilitation because of diseases of the skeletal system
The same applied to the proportion of individuals who were highly satisfied with the rehabilitative care received

Summary

Introduction

In many European countries, foreign nationals experience, on average, less favorable treatment outcomes in rehabilitative care than the respective majority population. Foreign nationals comprise increasingly large proportions of the populations in many European countries They differ in some health-related aspects from the majority populations of the countries they reside in. Nationals from Turkey, Former Yugoslavia and the South European countries Portugal, Spain, Italy and Greece constitute about half of the population of nonGerman nationals residing in Germany. Many of these individuals or their parents were recruited as labor migrants between the 1950s and the 1970s and settled in the country followed by their families [3]

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