title: Effectiveness of Medical Rehabilitation on Return-to-Work Depends on the Interplay of Occupation Characteristics and Disease.
abstract: Introduction Work disability causes high costs for economy, organizations, and employees. However, medical rehabilitation does not always enable employees to return to their old jobs. In the present study, we investigated how disease classification and work characteristics interact in predicting the success of medical rehabilitation in terms of one's ability to return to a former job. Methods To this end, we matched 2009 patient data from the German Statutory Pension Insurance agency with job characteristics data from the Occupational Information Network (O*NET) 17.0 database. We used a multilevel approach and a sample of N = 72,029, nested in 194 occupational groups. Results We found that workers are less likely to reenter a former job if mental illnesses coincide with emotionally demanding labor and if musculoskeletal diseases coincide with extreme environmental conditions. We did not find different effects between occupational groups for other types of diseases (circulatory system, neoplasms, injuries, others). Conclusion Thus, the contextual overlap of disease and occupational characteristics notably lowers the chances of a successful return-to-work. These findings should be taken into account by physicians when attempting to set realistic goals for rehabilitation in collaboration with the patient and the funding agency.
authors.affiliation: Innovation Incubator, Leuphana University Lüneburg, Rotenbleicher Weg 67, 21335, Lüneburg, Germany. anita.wiemer@gmx.net.|, Hopfenstrasse 21, 20359, Hamburg, Germany. anita.wiemer@gmx.net.
authors.forename: Anita
authors.initials: A
authors.lastname: Wiemer
authors.affiliation: Innovation Incubator, Leuphana University Lüneburg, Rotenbleicher Weg 67, 21335, Lüneburg, Germany.|RespectResearchGroup, University of Hamburg, Rothenbaumchaussee 34, 20148, Hamburg, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Mölders
authors.affiliation: Innovation Incubator, Leuphana University Lüneburg, Rotenbleicher Weg 67, 21335, Lüneburg, Germany.|, Mumsenstrasse 18, 22767, Hamburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Innovation Incubator, Leuphana University Lüneburg, Rotenbleicher Weg 67, 21335, Lüneburg, Germany.|Department of Psychiatry, Psychotherapy and Psychosomatics, Center for Social Psychiatry, Psychiatric Hospital, University of Zurich, Militärstrasse 8, P.O. Box 1930, 8021, Zurich, Switzerland.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Kawohl
authors.affiliation: Innovation Incubator, Leuphana University Lüneburg, Rotenbleicher Weg 67, 21335, Lüneburg, Germany.|University of Zurich, Militärstrasse 8, P.O. Box 1930, 8021, Zurich, Switzerland.|Laboratory of Neuroscience, Institute of Psychiatry, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, 05403-000, Brazil.
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
mesh_terms: D002318:Cardiovascular Diseases / Q000503:physiopathology; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000503:physiopathology; D015233:Models, Statistical; D009140:Musculoskeletal Diseases / Q000503:physiopathology; D009369:Neoplasms / Q000503:physiopathology; D009790:Occupations / Q000145:classification; D012050:Rehabilitation, Vocational / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D062707:Return to Work / Q000706:statistics & numerical data*
keywords: Multilevel analysis; Occupational disability; Occupational groups; Rehabilitation; Return to work