Effectiveness of Graded Return to Work After Multimodal Rehabilitation in Patients with Mental Disorders: A Propensity Score Analysis

被引：0
作者：
Marco Streibelt
Wolfgang Bürger
Karen Nieuwenhuijsen
Matthias Bethge
机构：
[1] German Federal Pension Insurance,Department of Rehabilitation
[2] fbg – Research and Consulting in Health Care,Coronel Institute of Occupational Health, Academic Medical Center
[3] Amsterdam Public Health Research Institute,Institute of Social Medicine and Epidemiology
[4] University of Lübeck,undefined
来源：
Journal of Occupational Rehabilitation | 2018年 / 28卷
关键词：
Graded return to work; Mental disorders; Propensity score matching;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
Purpose Graded return to work (GRTW) is a strategy aimed at bringing people gradually back to coping with a full workload after an extended period of sick leave. This study aims to determine the effect of GRTW in addition to a multimodal rehabilitation on longer-term work participation in people with chronic mental disorders (CMDs). Methods Patients filled out questionnaires at the start of a multimodal rehabilitation and 15 months later. Balanced groups (GRTW, no GRTW) were formed by propensity score matching based on 27 covariates. The primary outcome measures were the return to work (RTW) status at follow-up and the number of days on sick leave during follow-up. Results From 1062 data sets (GRTW 508, no GRTW 554), 381 pairs were matched (age: 47.8 years; 78% female; 65% affective disorders, 28% neurotic or somatic disorders). At follow-up, 88% of the GRTW group had returned to work compared to only 73% of the controls (RR = 1.22, 1.13–1.31). The mean sick leave duration during the follow-up period was 7.0 weeks in the GRTW group compared to 13.4 weeks in the control group (p < 0.001). Additional explorative analyses showed that these effects were only observed in patients with an unsure or negative subjective RTW prognosis. Conclusions Based on this analysis, GRTW in addition to a multimodal rehabilitation is effective in enhancing successful work participation in people with CMDs. Earlier studies showing larger effects in people with a higher risk of a non-RTW were confirmed.
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页码：180 / 189
页数：9
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