Self-reported work ability predicts health-related exit and absence from work, work participation, and death: longitudin
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ORIGINAL ARTICLE
Self‑reported work ability predicts health‑related exit and absence from work, work participation, and death: longitudinal findings from a sample of German employees Matthias Bethge1 · Katja Spanier1 · Stefanie Köhn2 · Anna Schlumbohm2 Received: 5 May 2020 / Accepted: 3 November 2020 © The Author(s) 2020
Abstract Objective The cohort study examined the performance of the Work Ability Index in predicting health-related exit and absence from work, work participation, and death among a sample of workers previously receiving sickness absence benefits. Methods Workers aged 40–54 years who received sickness absence benefits in 2012 completed the Work Ability Index in 2013. Outcomes were extracted from administrative data records covering the period until the end of 2016. Results Data for 2266 participants were included (mean age: 47.9 years; 54.4% women). Maximum follow-up was 43 months. In terms of work ability, 38.4% had good scores, 38.2% moderate scores, and 23.4% poor scores. Fully adjusted analyses showed an increased risk of a disability pension in workers with poor (HR = 12.98; 95% CI 5.81–28.99) and moderate Work Ability Index scores (HR = 3.17; 95% CI 1.36–7.38) compared to workers with good or excellent scores. The risk of a rehabilitation measure was also significantly increased for workers with poor and moderate scores. In addition, poor scores were prospectively associated with a longer duration of sickness absence and unemployment benefits, and fewer employment days and less income from regular employment. Those with poor Work Ability Index scores also had a significantly increased risk of premature death. Conclusions The Work Ability Index is a potential tool to identify individuals with previous long-term sickness absence having an increased risk of health-related exit and absence from work and poor work participation outcomes. Keywords Needs assessment · Occupational health · Rehabilitation · Pensions · Cohort study
Introduction The prevention of work disability and maintenance of work ability may require different actions, ranging from simple workplace adjustments to multi-component programmes. Particularly in cases with complex needs, coordinated care is essential to harmonise endeavours and services. This usually requires additional financial and staff resources. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00420-020-01608-4) contains supplementary material, which is available to authorized users. * Matthias Bethge [email protected] 1
Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
Institute of Medical Sociology and Rehabilitation Science, Charité, Universitätsmedizin Berlin, Berlin, Germany
2
Risk-adjusted and stepped-care models are approaches that may achieve both efficient use of resources and access to coordinated care by establishing treatments of different levels of intensity. This model is well known from psychiatric care (Hed
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