[Equal opportunities in access to medical rehabilitation]

Access to medical rehabilitation in Germany is largely standardized, yet influenced by various contextual conditions. This study examines the extent to which people with pre-existing disabilities face differences in access to medical rehabilitation compared with all people in need of rehabilitation.

Two qualitative studies were analyzed: MeReMBe (Medizinische Rehabilitation für Menschen mit einer vorbestehenden Behinderung) (2/2024-1/2026) and FöBeR(Förderliche Faktoren bei der Beantragung einer medizinischen Rehabilitation) (04/2021-08/2022). Both studies used maximum variation sampling. A total of 19 expert interviews and 8 focus groups with stakeholders involved in the rehabilitation process were conducted. The data were transcribed, pseudonymized, and analyzed using structuring content analysis.

Applications to rehabilitation are often initiated by relatives and other close persons as well as by general practitioners, who play a key role in the access process. Due to cognitive and communication impairments, for example, the usual communicative decision-making process is often not possible. In addition, the indication-oriented structure of the rehabilitation system impedes access because complex or multiple impairments often cannot be clearly assigned to a single indication category.

To support access to medical rehabilitation, potential rehabilitation patients and those involved in the process (e.g., relatives and healthcare professionals) require more low-threshold information and counseling options to fully benefit from the potential offered by medical rehabilitation. Diversity-related factors can interact in the access process and reinforce each other (e.g., disability and migration background). Complex or specific needs are insufficiently considered here, making it difficult to provide access to care.