Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany.
School of Public Health, Department of Epidemiology & International Public Health, Bielefeld University, Bielefeld, Germany.
BMJ Open. 2017 Aug 11;7(8):e015520. doi: 10.1136/bmjopen-2016-015520.
Rehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany.
We used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007-2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome.
Turkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for 'satisfaction with psychological care' and 0.11 (99.5% CI 0.08 to 0.14) for 'satisfaction with treatments during rehabilitation'. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation.
Turkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards rehabilitation. Rehabilitative care institutions need to provide services that are sensitive to the needs of all clients. Diversity management can contribute to this process.
在德国，医疗条件康复主要以住院服务的形式提供。与德国人相比，外国居民使用康复服务的频率较低，治疗效果也较差。这些差异与人口统计学、社会经济学和健康特征无关。对康复护理不同方面的满意度可能会影响康复服务的效果。我们比较了居住在德国的德国人和非德国国民对康复护理过程不同领域的满意度程度。
我们使用了德国法定养老金计划每年进行的康复患者横断面调查的数据。该样本包括 2007-2011 年间在 642 家医院接受医疗康复的 274513 人。参与者使用多项条目量表对不同康复领域的满意度进行评分。我们将每个量表分为低/中和高满意度。对于每个领域，我们进行了多层次调整的逻辑回归分析，以检查德国人和非德国国民之间满意度水平的差异。平均边际效应（AME）和 99.5%置信区间（CI）被计算为效应估计。AME 代表结果发生的概率差异。
土耳其国民对康复的大多数方面都不太满意，平均边际效应（AME）在 0.05（99.5%置信区间 0.00 至 0.09）之间，如“对心理护理的满意度”和 0.11（99.5%置信区间 0.08 至 0.14）之间，“对康复期间治疗的满意度”。来自前南斯拉夫、葡萄牙/西班牙/意大利/希腊的患者对康复的大多数方面与德国人一样满意。
土耳其国民对康复护理的满意度低于其他人群。这可能归因于人口对康复的期望存在多样性。康复护理机构需要提供对所有客户需求敏感的服务。多样性管理可以对此过程做出贡献。
