[Work Participation after Multimodal Rehabilitation due to Respiratory Diseases - Representative Analyses using Routine Data of the German Pension Insurance].

PURPOSE

For the German rehabilitation system there are only few representative findings on occupational reintegration after medical rehabilitation. For persons who have undergone rehabilitation on behalf of the German Pension Insurance (GPI) due to a respiratory disease, it is therefore needed to determine (a) what socio-medical risks exist prior to rehabilitation, (b) how well persons were able to participate in working life after rehabilitation, and (c) what conditions determine the work participation.

METHODS

The study is conducted on the basis of the GPI's database of rehabilitation statistics. Included were all persons, who completed medical rehabilitation in 2016 with a main discharged diagnosis from chapter J of the ICD-10. The analyses were carried out for the entire group and also in a differentiated manner for the the 2 main diseases bronchial asthma and COPD. Work participation was operationalized both via a monthly status variable until 24 months after rehabilitation and as a rate of all persons who were employed at the 12 and 24 months follow up and in the 3 months before, respectively. To analyze the factors influencing stable work participation, multiple logistic regression models with stepwise inclusion were calculated separately for the rates after 12 and 24 months.

RESULTS

A total of 19,287 data sets were included in the analysis (bronchial asthma: n=9,108, 47%; COPD: n=6,215, 32%). Patients with respiratory diseases were 53 years old on average, both genders were equally distributed. 14% had no absenteeism, 11 % stated an absence leave 6 months or more in the year prior to rehabilitation. Mental and cardiovascular comorbidity was documented in 39 and 38% of the cases, respectively. Overall, patients with COPD had higher socio-medical risks before rehabilitation than asthma patients. Accordingly, only about half of the COPD patients remained in active employment, while about 80% of the asthma patients succeeded in this. The strongest influencing factors on stable work participation were the time of sick leave as well as income prior to rehabilitation.

CONCLUSION

About two thirds of all persons with respiratory diseases are in stable employment after medical rehabilitation in Germany, with large differences between asthma bronchiale and COPD. In particular, the absenteeism as well as the wage before rehabilitation determine this. The analysis provides representative data on occupational reintegration after medical rehabilitation due to a respiratory disease for the first time.