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Langzeitarbeitsunfähigkeit und Wiederaufnahme der Arbeit

Konzeptionen und erste Ergebnisse einer internationalen Studie in Deutschland



Autor/in:

Weber, Andreas; Raspe, Heiner


Herausgeber/in:

Verband Deutscher Rentenversicherungsträger (VDR)


Quelle:

Deutsche Rentenversicherung, 1998, Heft 9/10, Seite 679-690, Bad Homburg v. d. H.: WDV Wirtschaftsdienst, ISSN: 0012-0018


Jahr:

1998



Abstract:


Das für die Systeme der sozialen Sicherung und ihrer Finanzierung bedeutsame Problem der Langzeitarbeitsunfähigkeit hat die International Social Security Association (ISSA) in Genf dazu bewogen, eine prospektive, multinationale Kohortenstudie zum Thema Work Incapacity and Reintegration anzuregen.

Dorsopathien dominieren die Morbiditätsstatistiken vieler Länder, weshalb sich die Studie auf diese für Sozialsysteme kostenintensive Gesundheitsstörung konzentriert. In Deutschland hat der Verband Deutscher Rentenversicherungsträger (VDR), unterstützt von den Bundesverbänden der Allgemeinen Ortskrankenkassen, der Betriebskrankenkassen und Innungskrankenkassen, das Institut für Sozialmedizin der Medizinischen Universität zu Lübeck beauftragt, die Studie durchzuführen. [...]

Ein Ziel der Studie ist es, Prädiktoren zu ermitteln, die über die Arbeitswiederaufnahme in den verschiedenen nationalen Gesundheitssystemen Auskunft geben. [...] Es zeigt sich ein hochsignifikanter Zusammenhang zwischen der subjektiven Prognose am 42. Tag der Arbeitsunfähigkeit und dem Erwerbsstatus zum Zeitpunkt der zweiten Befragung. [...] Daneben können für beide Gruppen erhebliche, klinisch relevante gesundheitliche Beeinträchtigungen festgestellt werden. [...] Die Tatsache, dass aber nur ein Drittel der Befragten einen Antrag auf medizinische Rehabilitation gestellt hat, deutet darauf hin, dass hier eine Unterinanspruchnahme der medizinischen Rehabilitation vorliegen dürfte.

[Aus: Autorenreferat]


Weitere Informationen:


Englisches Abstract:

Long-term Work Incapacity and Return to Work - Concept and First Results of a Cross-national Study in Germany


Abstract:


The significant problem of long-term work incapacity and its impact on social security systems and their financing induced the International Social Security Association (ISSA) in Geneva to initiate a prospective, cross-national cohort study called 'Work Incapacity and Reintegration'. Lower back impairments are heading many countries. For this reason, the study concentrated on this type of impairments which is a very cost-intensive factor for each social security system.

In Germany, the Federation of German Pension Insurance Institutes (VDR), supported by the Federations of the General Compulsory Medical Insurance Scheme (organised at district level), the Company Sickness lnsurance Scheme and the Guild Sickness Insurance Scheme, has entrusted the Institute for Social Medicine of the Medical University in Luebeck with the study. Patients sicklisted for three months due to back problems were repeatedly sent a postal questionnaire to analyse whether, when and how they returned to work. In Germany, all responses were competed by additional, anonymous data of the health insurance scheme.

One aim of the study was to evaluate predictors on those factors provoking a return to work in different health care systems. For rehabilitation institutes it is important to know whether a so-called 'risk profile' based on socio-demographic patterns is possible to trace and whether the need for prevention and intervention can be determined specifically by health insurance routine data.

This contribution presents the concept, questionnaire and first results of both initial measurements (day 42 and 84 after initial sick-leave). Analyses made for Germany up to now show that patients who are still unfit for work 84 days after their initial sick-leave differ already on day 42 from those who return to work on the 84th day with respect to their working prognosis and their subjective health status. However, the individual subjective work prognosis for the future as relevant return to work predictor is of great interest because this assessment involves individual life planning. Therefore, participants of the study were questioned on the 42nd day of sick-leave how they consider their situation in the long term.

A significant context was found between the subject prognosis after 42 days of sick-leave and the working status at the time of the second measurement. The subjective prediction of people saying 'I will not be able to work again' proved to be right and 90% of this group was still on sick-leave.

In addition, both groups showed significant health impairments indicating a need for intensive medical and rehabilitative care. Only about one third of the questioned patients applied for medical rehabilitation. This may indicate that too many patients waive their right on medical rehabilitation. 84 days after the initial sick-Ieave all individuals were questioned about possible early retirement. Only 12% of those being 42 days on sick-leave applied for early retirement, which means that the majority of the questioned patients on long-term sick-leave still does not want early retirement. But 37% do not entirely exclude this step and are reflecting on early retirement. Most patients on long-term sick-leave are striving for reintegration into work but still have not made their decision. A primary task of targeted medical rehabilitation must be to indicate the patient the perspective of reintegration into work, a task which underlines the importance of medical rehabilitation.


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Zeitschriftenbeitrag / Forschungsergebnis




Bezugsmöglichkeit:


Deutsche Rentenversicherung
Homepage: https://www.deutsche-rentenversicherung.de/DRV/DE/Ueber-uns-...

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Referenznummer:

R/ZA3432


Informationsstand: 26.04.1999

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