Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.
Pihlajalinna Työterveys, Tampere, Finland.
BMC Public Health. 2021 Oct 12;21(1):1847. doi: 10.1186/s12889-021-11873-8.
Work disability is a complex issue that requires preventive efforts from healthcare systems and individuals, and that too often results in disability pensions (DP). While many studies have attempted to characterize risk factors of work disability, many showing for example a link between socioeconomic positions, working conditions and frequent attendance to OH primary care it is not known if frequent attendance is associated with DP despite the sociodemographic factors. This study aims to address this gap and examine the association between frequent attendance to OH primary care and DP, when adjusted by sociodemographic factors.
This study combines routine medical record data of an occupational health service provider with comprehensive national registers. Medical record data were used to define groups of frequent attenders to OH primary care (FA) (1-year-FA, 2-year-FA, persistent-FA and non-FA) from 2014 to 2016. The sociodemographic factors (including i.e. educational level, occupational class, unemployment periods) were derived from Statistic Finland and DP decisions were derived from Finnish Centre for Pensions. Association of frequent attendance to OH primary care with DP decisions were analyzed and adjusted by sociodemographic factors.
In total, 66,381 patients were included. Basic and intermediate education along with manual and lower non-manual work predicted frequent attendance to OH primary care. Unemployment in 2013 did not predict frequent attendance to OH primary care. Frequent attendance to OH primary care was associated with DP within next two years, even when adjusted for sociodemographic factors. The association of frequent attendance to OH primary care with DP grew stronger as high service use persisted over time.
Frequent attendance to OH primary care is associated with DP risk in the near future despite the underlying sociodemographic differences. Patients using OH primary care services extensively should be identified and rehabilitative needs and measures necessary to continue in the work force should be explored. Sociodemographic issues that co-exist should be explored and considered when planning interventions.
工作残疾是一个复杂的问题，需要医疗保健系统和个人采取预防措施，而且往往会导致残疾抚恤金（DP）。尽管许多研究试图描述工作残疾的风险因素，例如许多研究表明社会经济地位、工作条件和经常接受 OH 初级保健之间存在关联，但尚不清楚尽管存在社会人口因素，经常接受 OH 初级保健是否与 DP 相关。本研究旨在解决这一差距，并研究在调整社会人口因素后，经常接受 OH 初级保健与 DP 之间的关联。
本研究结合了一家职业健康服务提供商的常规医疗记录数据和全面的国家登记册。使用医疗记录数据，从 2014 年至 2016 年定义了 OH 初级保健的频繁就诊者（FA）（1 年 FA、2 年 FA、持续 FA 和非 FA）组。社会人口因素（包括教育水平、职业类别、失业期）来自芬兰统计局，DP 决策来自芬兰养老金中心。分析并调整了社会人口因素后，研究了经常接受 OH 初级保健与 DP 决策之间的关联。
共有 66381 名患者入组。基础和中级教育以及体力劳动和较低的非体力劳动预测了 OH 初级保健的频繁就诊。2013 年的失业并没有预测 OH 初级保健的频繁就诊。即使在调整了社会人口因素后，经常接受 OH 初级保健与 DP 在接下来的两年内相关。随着高服务利用率的持续时间延长，OH 初级保健的频繁就诊与 DP 的关联变得更强。
尽管存在潜在的社会人口差异，但 OH 初级保健的频繁就诊与近期 DP 风险相关。应识别广泛使用 OH 初级保健服务的患者，并探索必要的康复需求和措施，以使其继续工作。在规划干预措施时，应探讨并考虑同时存在的社会人口问题。
