Original article

Scand J Work Environ Health 2016;42(4):273-279    pdf full text


Effects of graded return-to-work: a propensity-score-matched analysis

by Bethge M

Objectives Graded work exposure is deemed to have a therapeutic effect. In Germany, graded return-to-work (GRTW) is therefore frequently used following a rehabilitation program if workers are still unable to perform full job duties. The aim of the analyses was to determine long-term effects on disability pension and regular employment.

Methods Analyses were performed with longitudinal administrative data. Patients aged 18–60 years who attended an orthopedic, cardiac, oncological, or psychosomatic rehabilitation between January and June 2007 were eligible to participate in a GRTW scheme. The effects of GRTW were analyzed by a propensity-score-matched comparison of patients with and without GRTW. Outcomes were disability pension rates, regular income, and the duration of receiving welfare benefits due to sickness absence and unemployment up to the end of 2009.

Results The propensity-score-matched sample comprised 1875 patients on GRTW and 1875 matched controls not undergoing GRTW. The probability of a disability pension was decreased by about 40% among GRTW patients [5.4% versus 8.6%; hazard rate ratio (HR) 0.62, 95% confidence interval (95% CI) 0.49–0.80]. The three-year income (2007–2009) was EUR12 920 higher (95% CI EUR10 054–15 786) in the GRTW group. The duration of receiving welfare benefits due to sickness absence and unemployment was significantly reduced.

Conclusions Graded work exposure supports labor participation and reduces the risk of permanent work disability.

This article refers to the following texts of the Journal: 2012;38(1):27-37  2009;35(1):1-5  2012;38(2):120-133  2013;39(1):57-65  2014;40(1):47-56  2015;41(5):491-503
The following articles refer to this text: 2016;42(4):257-259; 2017;43(5):436-446; 2017;43(5):447-456