Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; The Clinical Institute, Aalborg University, Aalborg, Denmark.
The Clinical Institute, Aalborg University, Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Public Health. 2022 Oct;211:114-121. doi: 10.1016/j.puhe.2022.07.019. Epub 2022 Sep 8.
This study explores how the choice of voluntary early retirement (VER) affects mortality in a population where VER is available 5 years before regular retirement age.
This retrospective cohort study uses a registry-based follow-up design with access to Nationwide Danish Registry Data.
The study includes all Danish individuals who between 2000 and 2015 were part of an unemployment insurance fund and working at the time of their 60th (P60) or 62nd (P62) birthday. Those alive 1 year from their 60th or 62nd birthday were included in the mortality analysis. Individuals were registered as VER recipients if they chose the benefit within 1 year from P60 or P62. Three-year mortality likelihood following the first year from inclusion was explored for both cohorts separately. Multiple subgroups were explored in the mortality analysis, including individuals with chronic obstructive pulmonary disease (COPD), heart failure, and diabetes.
P60 included 627,278 individuals, and VER was chosen by 22.5%. P62 included 379,196 individuals, and VER was chosen by 33.4%. The likelihood of VER in the P60 was lower in healthy individuals (odds ratio [OR] 0.87, confidence interval [CI] 0.85-0.88) and higher in COPD (OR 1.15, CI 1.07-1.22) and heart failure patients (OR 1.15, CI 1.05-1.25). Three-year mortality was significantly higher in those choosing VER in P60 (OR 1.28, CI 1.22-1.34), which was also found for all health subgroups (healthy, OR 1.18, CI 1.07-1.30; COPD, OR 1.55, CI 1.16-2.07; heart failure, OR 1.42, CI 1.02-1.98; diabetes, OR 1.36, CI 1.12-1.65). The increased mortality risk was not found in the P62 cohort.
The choice of VER is more likely in patients with COPD and heart failure. VER in the P60 cohort is associated with an increased mortality likelihood, which was not found in the P62 cohort, which may be explained by health selection bias.
本研究探讨了在提前 5 年即可选择自愿提前退休（VER）的人群中，选择 VER 对死亡率的影响。
这是一项回顾性队列研究，采用基于登记的随访设计，可获取全国丹麦登记数据库的数据。
该研究纳入了 2000 年至 2015 年期间参加失业保险基金且在 60 岁（P60）或 62 岁（P62）生日时在职的所有丹麦个体。那些在其 60 岁或 62 岁生日的 1 年后仍然存活的个体被纳入死亡率分析。如果个体在 P60 或 P62 后 1 年内选择了该福利，则被登记为 VER 领取者。分别对两个队列进行了 1 年后的第 1 年的 3 年死亡率可能性的探索。在死亡率分析中还探索了包括慢性阻塞性肺疾病（COPD）、心力衰竭和糖尿病患者在内的多个亚组。
P60 队列包括 627278 人，其中 22.5%的人选择了 VER。P62 队列包括 379196 人，其中 33.4%的人选择了 VER。在健康个体中，P60 中选择 VER 的可能性较低（比值比 [OR] 0.87，置信区间 [CI] 0.85-0.88），而在 COPD 患者（OR 1.15，CI 1.07-1.22）和心力衰竭患者（OR 1.15，CI 1.05-1.25）中较高。在 P60 中选择 VER 的个体 3 年死亡率明显更高（OR 1.28，CI 1.22-1.34），在所有健康亚组中也发现了这种情况（健康个体，OR 1.18，CI 1.07-1.30；COPD 患者，OR 1.55，CI 1.16-2.07；心力衰竭患者，OR 1.42，CI 1.02-1.98；糖尿病患者，OR 1.36，CI 1.12-1.65）。在 P62 队列中未发现这种增加的死亡率风险。
在 COPD 和心力衰竭患者中更有可能选择 VER。P60 队列中选择 VER 与死亡率的可能性增加有关，但在 P62 队列中未发现这种情况，这可能是由于健康选择偏倚所致。
