[Social inequality as a predictor of occupational reintegration of chronic back pain patients following medical rehabilitation].
BACKGROUND
The question of which factors influence return to work following medical rehabilitative measures in the case of chronic back pain is, in a social political context, of international significance. While psychosocial, socio-economic and demographic factors as well as subjective perceptions of working conditions are individually discussed, the role of social inequality has thus far received little attention.


OBJECTIVE
The present paper focuses on the occupational reintegration of patients with chronic dorsopathies following a medical rehabilitative intervention and aims to investigate the influence of predictor variables on successful reintegration.


METHODS
The re-analysis conducted was based on a three-year prospective controlled intervention study with three measurement sessions. The study comprised a sample of 289 patients aged 20 to 64 years who had undergone first-time intervertebral disc operations in the lumbar spine region. Data were collected between March 2002 and February 2005 using a standardized written questionnaire. Winkler's (1998) composite index comprising indicators of occupational position, income and education was employed as a measure of social inequality. Age and sex were also included as independent variables in a binary logistic regression analysis.


RESULTS
Of individuals undergoing rehabilitation, those from lower social classes returned to work later than those from higher social classes. Age and sex did not prove to be significant predictors of successful return to work.


CONCLUSIONS
The probability of successful reintegration into working life increases according to the position within the vertical structure of social class. In light of this result, it can be assumed that not only differential allocation of patients to rehabilitation interventions but also the specific contents of these interventions should be modeled on the basis of economic criteria.
Hofreuter
K
K
Institut für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf. hofreute@uke.uni-hamburg.de
Koch
U
U
Morfeld
M
M
D000328:Adult; D001416:Back Pain / Q000453:epidemiology* / Q000534:rehabilitation*; D002908:Chronic Disease; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000534:rehabilitation*; D009788:Occupational Therapy / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012935:Social Justice; D012959:Socioeconomic Factors; D016896:Treatment Outcome