Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
Federal German Pension Insurance, Berlin, Germany.
J Occup Rehabil. 2021 Jun;31(2):376-382. doi: 10.1007/s10926-020-09926-7.
Purpose Unmet rehabilitation needs are common. We therefore developed a risk score using administrative data to assess the risk of permanent work disability. Such a score may support the identification of individuals with a high likelihood of receiving a disability pension. Methods Our sample was a random and stratified 1% sample of individuals aged 18-65 years paying pension contributions. From administrative records, we extracted sociodemographic data and data about employment and welfare benefits covering 2010-2012. Our outcome was a pension due to work disability that was requested between January 2013 and December 2017. We developed a comprehensive logistic regression model and used the model estimates to determine the risk score. Results We included 352,140 individuals and counted 6,360 (1.8%) disability pensions during the 5-year follow-up. The area under the receiver operating curve was 0.839 (95% CI 0.834 to 0.844) for the continuous risk score. Using a threshold of ≥ 50 points (20.2% of all individuals), we correctly classified 80.6% of all individuals (sensitivity: 71.5%; specificity: 80.8%). Using ≥ 60 points (9.9% of all individuals), we correctly classified 90.3% (sensitivity: 54.9%; specificity: 91.0%). Individuals with 50 to < 60 points had a five times higher risk of a disability pension compared to individuals with low scores, individuals with ≥ 60 points a 17 times higher risk. Conclusions The risk score offers an opportunity to screen for people with a high risk of permanent work disability.
未满足的康复需求较为常见。因此,我们利用行政数据开发了一种风险评分,以评估永久残疾的风险。这样的评分可以帮助识别那些极有可能领取残疾抚恤金的人。
我们的样本是一个随机分层的 1%的 18-65 岁缴纳养老金的个人样本。从行政记录中,我们提取了社会人口统计学数据以及 2010-2012 年的就业和福利数据。我们的结果是在 2013 年 1 月至 2017 年 12 月期间因工作残疾而申请的养老金。我们开发了一个综合的逻辑回归模型,并使用模型估计来确定风险评分。
我们纳入了 352140 人,并在 5 年的随访中记录了 6360 例(1.8%)残疾抚恤金。连续风险评分的接收者操作曲线下面积为 0.839(95%置信区间 0.834 至 0.844)。使用≥50 分(占所有人的 20.2%)的阈值,我们正确地将所有个体中的 80.6%分类(敏感性:71.5%;特异性:80.8%)。使用≥60 分(占所有人的 9.9%),我们正确地将 90.3%的个体分类(敏感性:54.9%;特异性:91.0%)。50 至<60 分的个体与低评分的个体相比,残疾抚恤金的风险增加了五倍,而≥60 分的个体,残疾抚恤金的风险增加了十七倍。
该风险评分提供了一种筛选永久性工作残疾高风险人群的机会。