Work Participation after Medical Rehabilitation of People with Musculoskeletal Diseases
Representative Analyses Using Routine Data of the German Pension Insurance
Purpose
We analyzed how people with musculoskeletal disorder who completed a rehabilitation program of the German Pension Insurance can be described before medical rehabilitation, how often work participation succeeds thereafter and which administratively available information is associated with work participation.
Methods
We used the German Pension Insurance’s rehabilitation statistics database. Patients with a musculoskeletal disorder who had completed medical rehabilitation in 2017 were included. The analyses were carried out for the group as a whole and stratified by diagnosis group. Work participation was conceptualized both via a monthly status variable up to 24 months after rehabilitation and as a rate of all persons who were employed 12 or 24 months after rehabilitation and the three preceding months. Multiple logistic regression models with stepwise inclusion were calculated to analyze the factors influencing stable work participation.
Results
The analysis included 335,792 completed orthopaedic rehabilitations. Two years after the end of rehabilitation, 66.2 percent of the patients achieved stable work participation. The most relevant factors influencing stable employment were the duration of sickness absence and the income from employment subject to social insurance contributions before the start of rehabilitation.
Conclusion
One and two years after completing orthopaedic rehabilitation, around seven out of ten patients are in stable employment. Due to their prognostic validity, the influencing factors identified can be used to determine needs and allocate patients to work-related medical rehabilitation, graded return-to-work and, if necessary, other services for participation in working life.
