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.

中文翻译：

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在德国为较高工作年龄的非移民和移民群体提供康复服务-lidA队列研究的结果。

背景技术老龄化和劳动力萎缩意味着防止因健康状况不佳而导致的过早离职将在未来变得更加重要。医疗康复是一项旨在积极参与工作生活的保健服务。这项服务的提供将与越来越多的老龄化劳动力有关，即具有移民背景的雇员及其不同的子群体。因此，本研究调查了具有移民背景的第一代和第二代雇员在使用康复服务方面是否不同于非移民者，以及在移民雇员子样本中，具有外国国籍的人是否不同于具有德国国籍的人。方法作为lidA队列研究（n = 6303）的一部分，于2011年在全国范围内对1959年或1965年出生的社会保险雇员进行了调查。第一个研究浪潮的调查数据用于确定康复利用的因变量（住院和门诊），移民状况的独立变量以及社会人口统计学，工作和非工作相关因素的协变量。应用具有独立性和逐块逻辑回归检验的双变量统计数据，研究了两组之间的差异。此外，计算了平均边际效应以直接比较调整后的模型。结果研究表明，第一代移民使用门诊康复的可能性显着低于非移民（完全调整为OR 0.42，95％CI 0.22-0。82），平均边际效应表明完整模型中的差异要大于零模型中的差异。比较住院康复或任何康复的利用情况或分析具有移民背景的德国和外国雇员时，第一代或第二代移民与非移民之间没有显着差异（n = 1148）。结论发现第一代移民和非移民在门诊康复利用上存在显着差异，这不能用社会人口统计学，工作和非工作相关因素来解释。因此，其他因素可能会起作用。第二代移民类似于非移民，而不是其父辈（第一代移民）。