["I would not even think of applying!" - Barriers to Claiming Benefits for Rehabilitation Services for Children and Adolescents from Families' Perspectives]

Rehabilitation (Stuttg). 2017 Apr;56(2):109-118. doi: 10.1055/s-0043-103063. Epub 2017 Apr 10.
[Article in German]

Abstract

Background Medical rehabilitation is recognized as an effective health care service to promote and protect health and social participation of children and adolescents. Although the number of children and adolescents with chronic conditions is growing, applications for rehabilitation have declined substantially since 2008. The aim of the study is to identify barriers that prevent families from claiming benefits for rehabilitation services and to give recommendations for actions. Methods In this explorative study, guided qualitative interviews with families with children and adolescents eligible for benefits were conducted. The analysis of the transcribed interviews followed the iterative process of content analysis (deductive and inductive development of main and sub-categories). Results 14 families (with 16 index-children) participated in the study. The results showed high levels of psychosocial burden of families and yet barriers to access services on a structural, disease-specific, and individual level. We identified three main topics in which families recommended modifications: (a) information policy, (b) family centeredness perspectives and flexibility, and (c) cross-sectoral collaboration/health care management. Conclusions Results indicate that families perceive the current pediatric rehabilitation services to lack fitting and flexibility. In general, a new approach of information and counselling, a more family centered perspective and integration of rehabilitation services in a comprehensive and coordinated health care structure are needed.

MeSH terms

  • Adolescent
  • Adolescent Health Services / economics
  • Adolescent Health Services / statistics & numerical data*
  • Child
  • Child Health Services / economics
  • Child Health Services / statistics & numerical data*
  • Child, Preschool
  • Cost of Illness
  • Family*
  • Female
  • Germany
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Insurance Benefits / economics
  • Insurance Benefits / statistics & numerical data*
  • Male
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Rehabilitation / economics
  • Rehabilitation / statistics & numerical data*