Shortage of Physicians in Rehabilitation Facilities - Results of a Quantitative Survey in German Rehabilitation Departments

Background Many high-income countries are experiencing a physicians' shortage. A large number of rehabilitation facilities in Germany are also having trouble keeping and recruiting physicians. So far no studies have been conducted into which departments and facilities with what indications and in which locations are worst affected. The objective of this article is to take an explorative approach to provide empirical indications on the phenomenon of physicians' shortages in rehabilitation facilities. Materials and Methods The data foundation for the exploratory analysis originates from a departmental survey encompassing all inpatient and outpatient rehabilitation facilities within the Quality Assurance Database of the German Pension Insurance (QS-REDA). The survey, with a thematic focus on medical professionals holding foreign qualifications, featured a section dedicated to the topic of physician workforce shortages, wherein n=373 departmental heads provided information on diverse indicators associated with the shortage of skilled professionals. Taking the three individual indicators of (1) vacancy period, (2) fluctuation rate and (3) the proportion of unfilled positions, we used a quartile split at the 25th and 75th percentile to create extreme groups (-1, 0, 1) and summed them up to an index. Departments that were empirically in the extreme groups on at least 2 individual indicators were classified as "high" on the shortage of skilled labour index. Bivariate correlations between the categories of the skilled labour shortage index and other structural and regional department variables are evaluated using chi-square tests. Results The results of the survey reveal that it is predominantly medium-sized facilities located in the periphery, with an in-patient or mixed treatment form and which do not focus on treating orthopaedic or rheumatic patients, that are experiencing physicians' shortages. The strongest correlation of the skilled labour shortage index is with the settlement-structural typification of the specialist department (chi(2)(8)=34.3; p <= 0.001). Conclusions The location of many rehabilitation facilities in rural areas presents an additional recruitment barrier for medical staff. The issue of physicians' shortages in rehabilitation facilities has not yet been the subject of research. It is to be expected that the number of physicians will fall even shorter of demand in future. Structured measures are needed to compensate for this.