Finnish Institute of Occupational Health, Helsinki, Finland.
Finnish Centre for Pensions, Helsinki, Finland.
PLoS One. 2019 Feb 21;14(2):e0212498. doi: 10.1371/journal.pone.0212498. eCollection 2019.
Understanding diverse labor market trajectories around vocational rehabilitation provides important insight into potential effectiveness of rehabilitation efforts. We examined factors associated with work participation trajectories before and after vocational rehabilitation.
Using nationwide Finnish register data of 7180 vocational rehabilitees, we constructed latent trajectory groups of work participation two years before and two years after their rehabilitation episode starting in 2008-2010. We plotted changes in labor market statuses in these groups and examined other associated factors using multinomial logistic regression.
We identified four trajectories based on work participation levels before and after vocational rehabilitation. The "High-Resumed" group (35.6%) typically returned to full duties. The "High-to-Negligible" group (20.7%) typically transitioned to full disability retirement or unemployment. Among the "Medium-Resumed" (25.5%) and "Longstanding Negligible" (18.3%) groups, work disability and unemployment were common before rehabilitation, but afterwards those assigned to the former group often returned to full or partial duties. Overall, older age, male gender, living in areas with lower employment rates, having lower education, being employed in the private sector, and having mental diagnoses were associated with the other three trajectories than the most favorable "High-Resumed" trajectory. Furthermore, certain industrial sectors, job exposures, and less common diagnoses further separated specific trajectories.
Work participation trajectories around vocational rehabilitation are diverse, only partly dependent on initial levels of work participation, and determined by various individual and work-related factors. Future nationwide studies should assess the effectiveness of vocational rehabilitation taking into consideration both individual and work-related factors.
了解职业康复前后不同的劳动力市场轨迹，对于了解康复工作的潜在效果具有重要意义。我们研究了职业康复前后与工作参与轨迹相关的因素。
利用 2008-2010 年期间开始的全国性芬兰职业康复人员的登记数据，我们构建了工作参与度在康复前两年和康复后两年的潜在轨迹组。我们绘制了这些组中劳动力市场地位的变化，并使用多项逻辑回归分析了其他相关因素。
我们根据职业康复前后的工作参与水平确定了四个轨迹组。“高恢复”组（35.6%）通常恢复到全职工作。“高到可忽略”组（20.7%）通常过渡到完全残疾退休或失业。在“中恢复”（25.5%）和“长期可忽略”（18.3%）组中，康复前工作残疾和失业很常见，但之后那些被分配到前者的人经常恢复到全职或部分工作。总体而言，年龄较大、男性、居住在就业率较低的地区、教育程度较低、在私营部门就业以及患有精神疾病与其他三种轨迹相关，而不是与最有利的“高恢复”轨迹相关。此外，某些行业、工作暴露和不常见的诊断进一步分离了特定的轨迹。
职业康复前后的工作参与轨迹是多样的，部分取决于初始工作参与水平，并受各种个人和工作相关因素的影响。未来的全国性研究应考虑到个人和工作相关因素，评估职业康复的效果。
