德国医学康复后的重返工作岗位：基于行政数据的个体因素和区域劳动力市场的影响
Return to work after medical rehabilitation in Germany: influence of individual factors and regional labour market based on administrative data.
作者信息
Hetzel Christian, Leinberger Sarah, Kaluscha Rainer, Kranzmann Angela, Schmidt Nadine, Mitschele Anke
机构信息
Institute for Quality Assurance in Prevention and Rehabilitation at the German Sport University in Cologne, Eupener Str. 70, 50933 Cologne, Germany.
Institute for Research in Rehabilitation Medicine at Ulm University, Bad Buchau, Germany.
出版信息
J Labour Mark Res. 2023;57(1):4. doi: 10.1186/s12651-023-00330-1. Epub 2023 Jan 20.
BACKGROUND
The influence of both individual factors and, in particular, the regional labour market on the return to work after medical rehabilitation is to be analyzed based on comprehensive administrative data from the German Pension Insurance and Employment Agencies.
METHOD
For rehabilitation in 2016, pre- and post-rehabilitation employment was determined from German Pension Insurance data for 305,980 patients in 589 orthopaedic rehabilitation departments and 117,386 patients in 202 psychosomatic rehabilitation departments. Labour market data was linked to the district of residence and categorized into 257 labour market regions. RTW was operationalized as the number of employment days in the calendar year after medical rehabilitation. Predictors are individual data (socio-demographics, rehabilitation biography, employment biography) and contextual data (regional unemployment rate, rehabilitation department level: percentage of patients employed before). The estimation method used was fractional logit regression in a cross-classified multilevel model.
RESULTS
The effect of the regional unemployment rate on RTW is significant yet small. It is even smaller (orthopaedics) or not significant (psychosomatics) when individual employment biographies (i.e., pre-rehabilitation employment status) are inserted into the model as the most important predictors. The interaction with pre-rehabilitation employment status is not substantial.
CONCLUSIONS
Database and methods are of high quality, however due to the nonexperimental design, omitted variables could lead to bias and limit causal interpretation. The influence of the labour market on RTW is small and proxied to a large extent by individual employment biographies. However, if no (valid) employment biographies are available, the labour market should be included in RTW analyses.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s12651-023-00330-1.
背景
基于德国养老保险和就业机构的综合行政数据，分析个体因素尤其是区域劳动力市场对医学康复后重返工作岗位的影响。
方法
对于2016年的康复情况，从德国养老保险数据中确定了589个骨科康复科室的305,980名患者以及202个身心康复科室的117,386名患者康复前后的就业情况。劳动力市场数据与居住地区相关联，并被划分为257个劳动力市场区域。重返工作岗位以医学康复后日历年度内的就业天数来衡量。预测因素包括个体数据（社会人口统计学、康复经历、就业经历）和背景数据（区域失业率、康复科室水平：康复前就业患者的百分比）。所使用的估计方法是交叉分类多层次模型中的分数对数回归。
结果
区域失业率对重返工作岗位的影响显著但较小。当将个体就业经历（即康复前就业状况）作为最重要的预测因素纳入模型时，这种影响甚至更小（骨科）或不显著（身心科）。与康复前就业状况的交互作用并不显著。
结论
数据库和方法质量很高，然而由于非实验设计，遗漏变量可能导致偏差并限制因果解释。劳动力市场对重返工作岗位的影响较小，并且在很大程度上由个体就业经历所代表。但是，如果没有（有效的）就业经历数据，劳动力市场应纳入重返工作岗位分析之中。
补充信息
在线版本包含可在10.1186/s12651-023-00330-1获取的补充材料。
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