Skip to main content

Advertisement

SpringerLink
Log in

Effectiveness of Medical Rehabilitation on Return-to-Work Depends on the Interplay of Occupation Characteristics and Disease

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ensminger ME, Celentano DD. Unemployment and psychiatric distress: social resources and coping. Soc Sci Med. 1988;27(3):239–47.

    Article  CAS  PubMed  Google Scholar 

  2. Butterworth P, Gill SC, Rodgers B, Anstey KJ, Villamil E, Melzer D. Retirement and mental health: analysis of the Australian national survey of mental health and well-being. Soc Sci Med. 2006;62(5):1179–91.

    Article  PubMed  Google Scholar 

  3. Brockmann H, Müller R, Helmert U. Time to retire—time to die? A prospective cohort study of the effects of early retirement on long-term survival. Soc Sci Med. 2009;69(2):160–4.

    Article  PubMed  Google Scholar 

  4. Gjesdal S, Haug K, Ringdal P, Maeland JG, Hagberg J, Roraas T, et al. Sickness absence with musculoskeletal or mental diagnoses, transition into disability pension and all-cause mortality: a 9-year prospective cohort study. Scand J Public Health. 2009;37(4):387–94.

    Article  PubMed  Google Scholar 

  5. Federal Association of Company Health Insurance Funds [BKK Bundesverband]. Competetive advantage health: Costs of health related diseases in Germany [Wettbewerbsvorteil Gesundheit: Kosten arbeitsbedingter Erkrankungen in Deutschland]; 2008. http://www.dnbgf.de/fileadmin/texte/Downloads/uploads/dokumente/2008/BKK_Broschuere_arbeitsbedingteGesundheitskosten_RZ_web.pdf.

  6. Henderson M, Glozier N, Holland Elliott K. Long term sickness absence. BMJ. 2005;330(7495):802–3.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Higgins A. The case for rehabilitation. Occup Health (Auckl). 2007;59(2):23–5.

  8. Josephson M, Heijbel B, Voss M, Alfredsson L, Vingård E. Influence of self-reported work conditions and health on full, partial and no return to work after long-term sickness absence. Scand J Work Environ Health. 2008;34(6):430–7.

    Article  PubMed  Google Scholar 

  9. Vestling M, Tufvesson B, Iwarsson S. Indicators for return to work after stroke and the importance of work for subjective well-being and life satisfaction. J Rehabil Med. 2003;35(3):127–31.

    Article  PubMed  Google Scholar 

  10. German Statutory Pension Insurance (Deutsche Rentenversicherung). Reha-Bericht Update 2011: Die medizinische und berufliche Rehabilitation der Rentenversicherung im Licht der Statistik. [Medical and vocational rehabilition of the German Statutory Pension Insurance in the light of statistics.] 2011. http://www.deutsche-rentenversicherung.de.

  11. Mittag O, Kolenda KD, Nordman KJ, Bernien J, Maurischat C. Return to work after myocardial infarction/coronary artery bypass grafting: patients’ and physicians’ initial viewpoints and outcome 12 months later. Soc Sci Med. 2001;52(9):1441–50.

    Article  CAS  PubMed  Google Scholar 

  12. Fang R, Duffy MK, Shaw JD. The Organizational Socialization Process: Review and Development of a Social Capital Model. J Manage. 2010;37(1):127–52.

    Google Scholar 

  13. Tomassen PC, Post MW, van Asbeck FW. Return to work after spinal cord injury. Spinal Cord. 2000;38(1):51–5.

    Article  CAS  PubMed  Google Scholar 

  14. Blank N, Diderichsen F. Short-term and long-term sick-leave in Sweden: relationships with social circumstances, working conditions and gender. Scand J Soc Med. 1995;23(4):265–72.

    CAS  PubMed  Google Scholar 

  15. Ekberg K, Wildhagen I. Long-term sickness absence due to musculoskeletal disorders: the necessary intervention of work conditions. Scand J Rehabil Med. 1996;28(1):39–47.

    CAS  PubMed  Google Scholar 

  16. Gomes J, Lloyd O, Norman N. The health of the workers in a rapidly developing country: effects of occupational exposure to noise and heat. Occup Med (Oxford, England). 2002;52(3):121–8.

    Article  CAS  Google Scholar 

  17. Parkes KR. Shiftwork, job type, and the work environment as joint predictors of health-related outcomes. J Occup Health Psych. 1999;4(3):256–68.

    Article  CAS  Google Scholar 

  18. Wickens CDHJ. Engineering psychology and human performance. Upper Saddle River: Prentice Hall; 1999.

    Google Scholar 

  19. Krause N, Lynch J, Kaplan GA, Cohen RD, Goldberg DE, Salonen JT. Predictors of disability retirement. Scand J Work Environ Health. 1997;23(6):403–13.

    Article  CAS  PubMed  Google Scholar 

  20. Ekberg K. Workplace changes in successful rehabilitation. J Occup Rehabil. 1995;5(4):253–69.

    Article  CAS  PubMed  Google Scholar 

  21. Krause N, Frank JW, Dasinger LK, Sullivan TJ, Sinclair SJ. Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for future research. Am J Ind Med. 2001;40(4):464–84.

    Article  CAS  PubMed  Google Scholar 

  22. Siegert RJ, Taylor WJ. Theoretical aspects of goal-setting and motivation in rehabilitation. Disabil Rehabil. 2004;26(1):1–8.

    Article  PubMed  Google Scholar 

  23. Soderberg S, Jumisko E, Gard G. Clients’ experiences of a work rehabilitation process. Disabil Rehabil. 2004;26(7):419–24.

    Article  PubMed  Google Scholar 

  24. Muchinsky PM, Raines JM. The overgeneralized validity of validity generalization. J Organ Behav. 2013;34(7):1057–60.

    Article  Google Scholar 

  25. Choi Y-H, Hu H, Tak S, Mukherjee B, Park SK. Occupational noise exposure assessment using O* NET and its application to a study of hearing loss in the US general population. Occup Environ Med. 2012;69(3):176–83.

    Article  PubMed  Google Scholar 

  26. Barnes AJ, Zimmerman FJ. Associations of occupational attributes and excessive drinking. Soc Sci Med. 2013;92:35–42.

    Article  PubMed  Google Scholar 

  27. Alterman T, Grosch J, Chen X, Chrislip D, Petersen M, Krieg E Jr, et al. Examining associations between job characteristics and health: linking data from the Occupational Information Network (O* NET) to two US national health surveys. J Occup Environ Med. 2008;50(12):1401–13.

    Article  PubMed  Google Scholar 

  28. Forstmeier S, Maercker A, Maier W, van den Bussche H, Riedel-Heller S, Kaduszkiewicz H, et al. Motivational reserve: motivation-related occupational abilities and risk of mild cognitive impairment and Alzheimer disease. Psychol Aging. 2012;27(2):353–63.

    Article  PubMed  Google Scholar 

  29. Fischer S, Wiemer A, Diedrich L, Moock J, Rossler W. Hell is other people? Gender and interactions with strangers in the workplace influence a person’s risk of depression. PLoS ONE. 2014;9(7):e103501.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Brzoska P, Voigtlander S, Spallek J, Razum O. Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany. Eur J Epidemiol. 2010;25(9):651–60.

    Article  PubMed  Google Scholar 

  31. World Health Organization [WHO]. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines: World Health Organization; 1992.

  32. Gogstad AC, Kjellman AM. Rehabilitation prognosis related to clinical and social factors in brain injured of different etiology. Soc Sci Med. 1976;10(6):283–8.

    Article  CAS  PubMed  Google Scholar 

  33. Tan V, Cheatle MD, Mackin S, Moberg PJ, Esterhai JL. Goal setting as a predictor of return to work in population of chronic musculoskeletal pain patients. Int J Neurosci. 1997;92(3–4):161–70.

    Article  CAS  PubMed  Google Scholar 

  34. Bloch FS, Prins R. Who returns to work & why? A six-country study on work incapacity & reintegration (Vol. 5): Transaction Publishers; 2001.

  35. Cheadle A, Franklin G, Wolfhagen C, Savarino J, Liu PY, Salley C, et al. Factors influencing the duration of work-related disability: a population-based study of Washington State workers’ compensation. Am J Public Health. 1994;84(2):190–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Kemmlert K, Lundholm L. Factors influencing ergonomic conditions and employment rate after an occupational musculoskeletal injury. J Occup Rehabil. 1994;4(1):11–21.

    Article  CAS  PubMed  Google Scholar 

  37. Hochschild AR. The Managed Heart: Commercialization of Human Feeling. California: University of California Press; 1983.

    Google Scholar 

  38. Snijders TAB, Bosker RJ. Multilevel Analysis: An Introduction to Basic and Advanced Multilevel Modeling. Thousand Oaks: SAGE Publications; 2011.

    Book  Google Scholar 

  39. Rodriguez G, Elo I. Intra-class correlation in random-effects models for binary data. Stata J. 2003;3(1):32–46.

    Google Scholar 

  40. Rosenthal R, Jacobson L. Pygmalion in the classroom. Urban Rev. 1968;3(1):16–20.

    Article  Google Scholar 

  41. Benavides FG, Benach J, Moncada S. Working conditions and sickness absence: a complex relation. J Epidemiol Commun H. 2001;55(5):368.

    Article  CAS  Google Scholar 

  42. Bonde JP, Rasmussen MS, Hjollund H, Svendsen SW, Kolstad HA, Jensen LD, et al. Occupational disorders and return to work: a randomized controlled study. J Rehabil Med. 2005;37(4):230–5.

    Article  PubMed  Google Scholar 

  43. Wiles R, Ashburn A, Payne S, Murphy C. Discharge from physiotherapy following stroke: the management of disappointment. Soc Sci Med. 2004;59(6):1263–73.

    Article  PubMed  Google Scholar 

  44. Chapin MH, Kewman DG. Factors affecting employment following spinal cord injury: a qualitative study. Rehabil Psychol. 2001;46(4):400.

    Article  Google Scholar 

  45. Grahn BE, Borgquist LA, Ekdahl CS. Motivated patients are more cost-effectively rehabilitated. A two-year prospective controlled study of patients with prolonged musculoskeletal disorders diagnosed in primary care. Int J Technol Assess Health Care. 2000;16(3):849–63.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Innovation Incubator, Leuphana University Lüneburg, Rotenbleicher Weg 67, 21335, Lüneburg, Germany

    Anita Wiemer, Christina Mölders, Sebastian Fischer, Wolfram Kawohl & Wulf Rössler

  2. Department of Psychiatry, Psychotherapy and Psychosomatics, Center for Social Psychiatry, Psychiatric Hospital, University of Zurich, Militärstrasse 8, P.O. Box 1930, 8021, Zurich, Switzerland

    Wolfram Kawohl

  3. University of Zurich, Militärstrasse 8, P.O. Box 1930, 8021, Zurich, Switzerland

    Wulf Rössler

  4. Laboratory of Neuroscience, Institute of Psychiatry, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, 05403-000, Brazil

    Wulf Rössler

  5. Hopfenstrasse 21, 20359, Hamburg, Germany

    Anita Wiemer

  6. RespectResearchGroup, University of Hamburg, Rothenbaumchaussee 34, 20148, Hamburg, Germany

    Christina Mölders

  7. Mumsenstrasse 18, 22767, Hamburg, Germany

    Sebastian Fischer

Authors
  1. Anita Wiemer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christina Mölders
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sebastian Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wolfram Kawohl
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wulf Rössler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anita Wiemer.

Ethics declarations

Conflicts of interest

Anita Wiemer, Christina Mölders, Sebastian Fischer, Wolfram Kawohl, and Wulf Rössler declare that they have no conflict of interest.

Ethics Statement

For our manuscript we analyzed data that was collected for documentation purposes by the German Statutory Pension Insurance (GSPI). Due to the documentary nature of the data, we could not obtain informed consent of the patients analyzed. The Research Data Center of the GSPI (FDZ-RV) provides researchers with micro-sets from these data in form of Public Use Files or Scientific Use Files. The Research Data Center strictly protects patients’ privacy in terms of full data anonymization.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 26 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wiemer, A., Mölders, C., Fischer, S. et al. Effectiveness of Medical Rehabilitation on Return-to-Work Depends on the Interplay of Occupation Characteristics and Disease. J Occup Rehabil 27, 59–69 (2017). https://doi.org/10.1007/s10926-016-9632-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-016-9632-7

Keywords

Search

Navigation