Rehabilitation utilization of non-migrant and migrant persons with back pain: A cohort study using different definitions of migrant background
Summary: Background: Medical rehabilitation (MR) by the German Pension Insurance is approved to maintain and to restore work ability and to avoid disability pensions. Studies on the rehabilitation utilization by people with a migration background (PMB) compared to people without a migration backgro...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-04-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022000815 |
| _version_ | 1828848131324772352 |
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| author | David Fauser Hannes Banaschak Julia-Marie Zimmer André Golla Nadine Schmitt Wilfried Mau Matthias Bethge |
| author_facet | David Fauser Hannes Banaschak Julia-Marie Zimmer André Golla Nadine Schmitt Wilfried Mau Matthias Bethge |
| author_sort | David Fauser |
| collection | DOAJ |
| description | Summary: Background: Medical rehabilitation (MR) by the German Pension Insurance is approved to maintain and to restore work ability and to avoid disability pensions. Studies on the rehabilitation utilization by people with a migration background (PMB) compared to people without a migration background (non-PMB) showed heterogeneous results, which may be partly due to different definitions of migration status. The aim of this paper was to test whether there are differences in utilization of MR between employed PMB and non-PMB with self-reported back pain. Methods: We used data from a large German cohort study that analyzed the effectiveness of MR for individuals with back pain and was conducted between 1st January 2017 and 31st December 2019. Employees aged 45 to 59 years who reported back pain in the last three months completed the baseline questionnaire in 2017. We used four definitions of migration background (MB) to differentiate by first- and second-generation migration, by one- and two-sided migration background, by language, or by nationality. Data on rehabilitation utilization was extracted from administrative records covering the period until the end of 2018. Findings: Data of 6,713 participants were included, and 514 individuals utilized MR during follow-up. Adjusted analyses showed a decreased risk of rehabilitation utilization in people with a first-generation MB (HR = 0·46; 95% CI 0·29; 0·72), people with a two-sided MB (HR = 0·47; 95% CI 0·31; 0·72), people whose native language was not German (HR = 0·52; 95% CI 0·30; 0·91), and people without German nationality (HR = 0·29; 95% CI 0·12; 0·72) when compared to non-PMB. Interpretation: This study showed that employees with a MB reporting back pain had a significantly reduced risk for utilization of rehabilitation services. This underutilization could be observed considering different definitions of MB. Future research on rehabilitation utilization by PMB should consider the impact of different definitions on the results. Funding: The study was funded by the German Research Foundation (grant numbers: BE 5885/2–1; MA 6981/2–1). The German Research Foundation functions as a self-governing institution for the promotion of science and research in Germany. |
| first_indexed | 2024-12-12T22:24:01Z |
| format | Article |
| id | doaj.art-3c649b2bd1cd4fb59bfb3318c031be70 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-12T22:24:01Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-3c649b2bd1cd4fb59bfb3318c031be702022-12-22T00:09:49ZengElsevierEClinicalMedicine2589-53702022-04-0146101351Rehabilitation utilization of non-migrant and migrant persons with back pain: A cohort study using different definitions of migrant backgroundDavid Fauser0Hannes Banaschak1Julia-Marie Zimmer2André Golla3Nadine Schmitt4Wilfried Mau5Matthias Bethge6Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany; Corresponding author.Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, GermanyInstitute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyInstitute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyInstitute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyInstitute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyInstitute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, GermanySummary: Background: Medical rehabilitation (MR) by the German Pension Insurance is approved to maintain and to restore work ability and to avoid disability pensions. Studies on the rehabilitation utilization by people with a migration background (PMB) compared to people without a migration background (non-PMB) showed heterogeneous results, which may be partly due to different definitions of migration status. The aim of this paper was to test whether there are differences in utilization of MR between employed PMB and non-PMB with self-reported back pain. Methods: We used data from a large German cohort study that analyzed the effectiveness of MR for individuals with back pain and was conducted between 1st January 2017 and 31st December 2019. Employees aged 45 to 59 years who reported back pain in the last three months completed the baseline questionnaire in 2017. We used four definitions of migration background (MB) to differentiate by first- and second-generation migration, by one- and two-sided migration background, by language, or by nationality. Data on rehabilitation utilization was extracted from administrative records covering the period until the end of 2018. Findings: Data of 6,713 participants were included, and 514 individuals utilized MR during follow-up. Adjusted analyses showed a decreased risk of rehabilitation utilization in people with a first-generation MB (HR = 0·46; 95% CI 0·29; 0·72), people with a two-sided MB (HR = 0·47; 95% CI 0·31; 0·72), people whose native language was not German (HR = 0·52; 95% CI 0·30; 0·91), and people without German nationality (HR = 0·29; 95% CI 0·12; 0·72) when compared to non-PMB. Interpretation: This study showed that employees with a MB reporting back pain had a significantly reduced risk for utilization of rehabilitation services. This underutilization could be observed considering different definitions of MB. Future research on rehabilitation utilization by PMB should consider the impact of different definitions on the results. Funding: The study was funded by the German Research Foundation (grant numbers: BE 5885/2–1; MA 6981/2–1). The German Research Foundation functions as a self-governing institution for the promotion of science and research in Germany.http://www.sciencedirect.com/science/article/pii/S2589537022000815Medical rehabilitationMigration backgroundAssessmentUtilization |
| spellingShingle | David Fauser Hannes Banaschak Julia-Marie Zimmer André Golla Nadine Schmitt Wilfried Mau Matthias Bethge Rehabilitation utilization of non-migrant and migrant persons with back pain: A cohort study using different definitions of migrant background EClinicalMedicine Medical rehabilitation Migration background Assessment Utilization |
| title | Rehabilitation utilization of non-migrant and migrant persons with back pain: A cohort study using different definitions of migrant background |
| title_full | Rehabilitation utilization of non-migrant and migrant persons with back pain: A cohort study using different definitions of migrant background |
| title_fullStr | Rehabilitation utilization of non-migrant and migrant persons with back pain: A cohort study using different definitions of migrant background |
| title_full_unstemmed | Rehabilitation utilization of non-migrant and migrant persons with back pain: A cohort study using different definitions of migrant background |
| title_short | Rehabilitation utilization of non-migrant and migrant persons with back pain: A cohort study using different definitions of migrant background |
| title_sort | rehabilitation utilization of non migrant and migrant persons with back pain a cohort study using different definitions of migrant background |
| topic | Medical rehabilitation Migration background Assessment Utilization |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022000815 |
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