National Research Centre for the Working Environment, Copenhagen, Denmark.
Int J Occup Med Environ Health. 2012 Jun;25(2):200-4. doi: 10.2478/S13382-012-0017-7. Epub 2012 Apr 10.
In the period 1997-2005, the Danish government initiated a series of legislative changes aimed at facilitating RTW (return to work) in the Danish population. In the present study, we investigated the odds of being gainfully occupied ca. two years after stroke as a function of onset calendar year, 1996-2006.
All previously employed 20-57 year-old stroke patients in Denmark 1996-2006 (N = 19985) were followed prospectively through national registers. The analysis was controlled for the type of stroke and a series of demographic, structural and occupational variables.
The odds for RTW increased significantly during the study period (P < 0.0001). The odds at the end of the period were more than twice as high as they were at the beginning, even after post hoc control for improved survival and decreased unemployment rates. The most conspicuous increase coincided with a change in the sickness benefit act that took place in 2005.
The study provides quite strong circumstantial evidence that the legislative changes had an effect on the odds of return to work after stroke. More direct evidence is desirable, but such can only be obtained through a randomized controlled study.
在 1997 年至 2005 年期间，丹麦政府出台了一系列立法改革措施，旨在促进丹麦人口重返工作岗位。本研究旨在探讨 1996 年至 2006 年期间，发病年份与卒中后两年内有酬工作的几率之间的关系。
通过国家登记册，对丹麦 1996 年至 2006 年间所有 20-57 岁之间、曾有过工作经历的卒中患者进行前瞻性随访。分析时对卒中类型以及一系列人口统计学、结构和职业变量进行了控制。
在研究期间，重返工作的几率显著增加（P<0.0001）。在研究期末，重返工作的几率是研究初期的两倍多，即使在事后考虑到生存率提高和失业率下降的因素后也是如此。最显著的增加与 2005 年《病假法》的变化相吻合。
该研究提供了相当有力的间接证据，表明立法改革对卒中后重返工作的几率产生了影响。需要更直接的证据，但只能通过随机对照研究获得。
