Socioeconomic Trends in Outcomes of Rehabilitation Among Patients With Systemic Connective Tissue Disorders in Germany: A Cross-Sectional Analysis of Routine Data

Abstract

Objective

Various demographic factors, including sex, socioeconomic status, and immigration status, have been linked to disparities in healthcare outcomes. Despite efforts by healthcare providers to address these inequities, interventions are not always effective. The present investigation provides empirical insights from Germany focusing on patients with systemic connective tissue disorders, highlighting the need for evaluated strategies to mitigate healthcare disparities.

Methods

A 10% random sample of 2006–2016 routine data on patients with systemic connective tissue disorders (ICD-10 M30–M36) is used. The sample included information on 1819 patients. The primary outcome assessed was the persistence of impairment following rehabilitation treatment. Logistic regression models were employed to adjust for demographic confounders. Interaction analyses were conducted to explore variations in disparities across different time periods and diagnostic groups.

Results

Non-German nationals were at 87% higher odds of impairment after treatment compared to German nationals (adjusted odds ratio [aOR] = 1.87; 95% confidence interval [CI] = 1.22–2.86). Furthermore, patients employed in semi-skilled or unskilled positions demonstrated a 40% greater chance of poor outcomes compared to those in skilled occupations (aOR = 1.40; 95% CI = 1.03–1.90). Disparities in outcomes did not significantly vary across different years in which services were utilized.

Conclusion

The study demonstrates disparities in healthcare outcomes associated with various diversity characteristics. These disparities are likely due to the different obstacles that some disadvantaged population groups encounter in the healthcare system. To address this heterogeneity, diversity-sensitive healthcare provision strategies need to be implemented.