Inanspruchnahme medizinischer Rehabilitation in Abhängigkeit beruflicher Qualifikation bei älteren Beschäftigten: eine Querschnittuntersuchung auf Basis der 4. Welle der lidA-Studie

Older employees make up a large proportion of the labour force in Germany. Medical rehabilitation can help to keep them healthy in working life. The study examines the extent to which the utilisation of rehabilitation services by employees over the age of 50 differs depending on their occupational qualification.The data set consisted of 6,953 socially insured employees born in 1959, 1965 or 1971 from the fourth wave of the lidA cohort study ("leben in der Arbeit") 2022/2023. A cross-sectional analysis was conducted to determine whether they had utilised rehabilitation services in the last four years depending on their occupational qualification. In the multiple logistic regression analysis, adjustments were made for demographic characteristics, subjective health, work stress, physical workloads, work-privacy conflict and caregiving for relatives. Potential selection effects in recruitment and follow-up were addressed using combined longitudinal and cross-sectional weighting. In addition to odds ratios, average marginal effects were calculated.17.5% of older employees had undergone medical rehabilitation (13.1% inpatient, 4.4% outpatient). Low-skilled workers (OR: 1.28; 95% CI: 1.05-1.57) and medium-skilled workers (OR: 1.45; 95% CI: 1.19-1.77) had a higher chance of utilising rehabilitation services than high-skilled workers. High work stress (OR: 1.23; 95% CI: 1.04-1.46) and poor health (OR: 2.75; 95% CI: 2.40-3.16) were associated with a higher likelihood of utilising rehabilitation services, younger age (OR: 0.75; 95% CI: 0.63-0.89), female gender (OR: 0.81; 95% CI: 0.71-0.94) and a first-generation migration background (OR: 0.72; 95% CI: 0.58-0.90) were associated with a lower chance of utilising rehabilitation services.Rehabilitation utilisation depends on occupational qualification, as expected among the low-skilled. Subjective health explains a large part of the higher probability of utilisation of rehabilitation services in this group compared to the high-skilled. Compared to high-skilled individuals, medium-skilled and low-skilled older employees had a similarly high chance of utilising rehabilitation services. Future research should therefore examine the relationship between the need for and utilisation of medical rehabilitation services depending on the level of occupational qualification, taking other factors into account.