Einfluss beruflicher Problemlagen auf den Beschäftigungsstatus sechs Monate nach stationärer neurologischer Rehabilitation

2020 ◽  
Author(s):  
Stella Flemmer ◽  
Melanie Boltzmann ◽  
Simone Schmidt ◽  
Jens D. Rollnik
Keyword(s):  
Return To Work ◽  
Work Rate ◽  
Eine Hohe ◽  
Neurologische Rehabilitation

Zusammenfassung Ziel der Studie Durch die Identifikation beruflicher Problemlagen (BPL) können frühzeitig berufsbezogene Maßnahmen in die neurologische Rehabilitation integriert und somit die Return-to-Work-Rate erhöht werden. In der vorliegenden Studie soll untersucht werden, ob zu Rehabilitationsbeginn identifizierte BPL mit dem Erwerbsstatus sechs Monate nach Abschluss stationärer neurologischer Rehabilitation assoziiert sind. Methodik Aus der Klinikdatenbank wurden retrospektiv 122 Rehabilitanden ausgewählt, die in der BDH-Klinik Hessisch Oldendorf eine Anschlussrehabilitation absolvierten. Berufliche Problemlagen wurden mittels Selbstbeurteilung (Würzburger Screening [WS]) und einer ICF-konformen ärztlichen Einschätzung („d850“) zu Rehabilitationsbeginn identifiziert. Zusätzlich wurden sechs Monate nach Abschluss der Rehabilitation Daten zur aktuellen beruflichen Situation der Patienten erhoben. Ergebnisse Zu Beginn der Rehabilitation wiesen 25% der Rehabilitanden eine hohe BPL und 26% der Rehabilitanden eine sehr hohe BPL auf. Zum Katamnesezeitpunkt sechs Monate nach Abschluss der stationären Rehabilitation waren 63% der Rehabilitanden mit hohen oder sehr hohen BPL erwerbstätig. Die Return-to-Work-Rate lag insgesamt bei 73%. Während die im WS identifizierte BPL mit dem Erwerbsstatus zum Katamnesezeitpunkt assoziiert war (r = −0,288; p = ,007), gab es keinen Zusammenhang zwischen der ärztlichen Einschätzung der beruflichen Beeinträchtigung und dem Erwerbsstatus. In binär logistischen Regressionsmodellen zur Vorhersage des Erwerbsstatus erwiesen sich die Dauer der Arbeitsunfähigkeit, das Alter, das Geschlecht und die leistungsmedizinische Beurteilung zu Rehabilitationsende als Prädiktoren für den Erwerbsstatus. Schlussfolgerung Berufliche Problemlagen sind mit dem Erwerbsstatus sechs Monate nach stationärer neurologischer Rehabilitation assoziiert. Da diese in der Behandlungsplanung berücksichtigt werden, wird der Einfluss auf die Return-to-Work-Rate in der aktuellen Untersuchung möglicherweise unterschätzt.

Geschlechterunterschiede im Verlauf und Erfolg psychosomatischer Rehabilitation

2019 ◽  
Vol 29 (04) ◽  
pp. 190-198
Author(s):  
Nele von Hörsten ◽  
Wolfgang Schulz ◽  
Scott Stock Gissendanner ◽  
Gerhard Schmid-Ott
Keyword(s):  
Return To Work ◽  
Work Rate ◽  
Oder Eine ◽  
Eine Hohe

Zusammenfassung Fragestellung Ziel dieser Studie ist es, die Bedeutsamkeit des Geschlechts im Verlauf und Erfolg psychosomatischer Rehabilitation genauer zu bestimmen. Methoden Die Stichprobe besteht aus 401 Rehabilitanden einer stationären psychosomatischen Rehabilitation, 72% Frauen, 28% Männer, Durchschnittsalter 49 Jahre. Sie wurden zu Rehabilitationsbeginn, -ende sowie 12 Monate danach befragt. Die Rücklaufquote zum Follow-up beträgt 74%. Ergebnisse Die Ergebnisse zum Verlauf zeigen bei fast allen untersuchten Variablen signifikante Verbesserungen, am deutlichsten bei den ressourcenbezogenen bzw. klinischen Merkmalen (Selbstregulationsfähigkeit, Resilienz, Symptombelastung) und dem objektiven, für den Rehabilitationserfolg wichtigsten Indikator Return-to-Work. Allerdings zeigten die Untersuchungen der anderen arbeitsbezogenen Variablen geschlechtsunabhängig nur sehr geringe Verbesserungen (subjektive Prognose der Erwerbstätigkeit) oder eine Verringerung (Arbeitsmotivation). Die Effektstärken zu den Verbesserungen der ressourcenbezogenen und klinischen Merkmale liegen bei den Frauen (d=0,67 bis 1,35) etwas höher als bei den Männern (d=0,55 bis 0,93), obgleich die Return-to-Work-Rate bei Männern etwas höher ist (78 vs. 71%). Subgruppenanalysen kommen zu dem Ergebnis, dass für beide Geschlechter eine unterdurchschnittliche Symptombelastung und eine hohe Resilienz vorteilhaft für die Rückkehr in den Beruf sind. Schlussfolgerung Arbeitsplatzbezogenen Merkmalen sollte sowohl bei Frauen als auch bei Männern in der psychosomatischen Rehabilitation eine größere Bedeutung eingeräumt werden.

scholarly journals Quality evaluation of workers’ compensation hospital in Korea

2014 ◽  
Vol 9 ◽  
Author(s):  
Jong-Uk Won
Keyword(s):  
Health Care ◽  
Occupational Health ◽  
Return To Work ◽  
Hospital Stay ◽  
Evaluation Method ◽  
Length Of Hospital Stay ◽  
Work Rate ◽  
Injured Workers ◽  
Workers Compensation ◽  
Occupational Health Care

Background: The length of hospital stay among occupationally injured workers was too long comparing to national health insurance patients in Korea. Also return-to-work rate was low comparing to other countries. The Korea Workers’ Compensation & Welfare (COMWEL) has tried to upgrade the quality of care workers’ compensation contract hospitals since several years. One of the tries was to evaluate the workers’ compensation contract hospitals. However, many hospitals argued the appropriateness of the hospital evaluation.Objectives: This study was performed to evaluate the appropriateness of the workers’ compensation contract hospital evaluation.Methods: The total number of 500 hospitals was selected to evaluate among about 5,500 contracts hospitals according to their size or the number of occupationally injured patients. The main evaluation items were hospital facilities and equipment, health personnel, including doctors, record keeping, appropriateness of hospital care, outcomes, including return-to-work, length of hospital stay, satisfaction, etc. Multiple logistic regression was performed to evaluate the appropriateness of the results of this hospital evaluation. The dependent variables were return-to-work rate and length of hospital stay and independent variables were severity of injured workers, disability rate, company size, etc.Results: The hospitals were classified three categories according to the evaluation score; high, middle, and low quality. The return-to-work rate of high-quality hospitals was significantly higher (odds ratio 1.81; CI 1.27 – 2.58) than others. However, the length of hospital stay was not different among them.Conclusion: Return-to-work rate is one of the useful indicators for evaluating the occupational health care. Even though these are preliminary results, this evaluation method for the occupational health care hospitals would be appropriate for the purpose. The more specific analysis should be needed.

Vocational Potential and Spinal Cord Injuries - A Review and Evaluation

1994 ◽  
Vol 25 (3) ◽  
pp. 47-52 ◽  
Author(s):  
Gregory C. Murphy ◽  
James A. Athanasou
Keyword(s):  
Spinal Cord ◽  
Return To Work ◽  
Large Scale ◽  
Spinal Cord Injuries ◽  
Work Rate ◽  
Point Of View ◽  
Post Injury ◽  
Average Return ◽  
Ethnographic Studies ◽  
Spinal Cord Injured

The purpose of this paper is to review the vocational potential of spinal cord injured persons. The results of 17 recent (1976-1991) studies were reviewed. A diversity of study outcomes was indicated and the return to work rates varied from a low of 13% to a high of 69%. A total of 3568 subjects participated in the 17 studies and an estimated 56% of these were described specifically as paraplegics, 44% quadriplegics. Sample sizes within the reports ranged from small ethnographic studies of 15 to large scale follow-up surveys of 760. The results of these independent studies were combined. Overall, 1441 or 40.3% of all the 3568 subjects sampled in the 17 studies returned to work post-injury. For subjects who were followed-up less than five years post-injury, the average return to work rate was 37.9%; for subjects who were followed up at periods exceeding five years post-injury, the return to work rate was higher at 48.6%. From the methodological point of view, some standard measures of outcome are required. It was concluded that the results of these 17 studies are encouraging and indicate the potential of persons with a range of spinal cord injuries.

scholarly journals Return to work rate rises in the Sunshine State (Queensland, Australia)

2014 ◽  
Vol 9 ◽  
Author(s):  
Sharon Stratford
Keyword(s):  
Return To Work ◽  
Work Rate ◽  
Injured Workers ◽  
Work Outcomes ◽  
Workers Compensation ◽  
Annual Survey ◽  
Work Outcome ◽  
State Records

Measuring return to work outcomes after injury is in itself a challenge for most workers’ compensation schemes. Increasing return to work rates is even more difficult. In Australia, the national return to work measure obtained via an annual survey of injured workers has not risen since its introduction in 1997/98. However, unlike most other Australian jurisdictions, Queensland, Australia's ‘sunshine state’, records return to work outcomes at the end of every time lost claim. More than this, Queensland has increased its overall return to work outcome in recent years from 90% to over 95%. A number of specific strategies were introduced to improve these return to work results. The presentation will outline these strategies which other jurisdictions and countries can hopefully learn from. In addition, WorkCover Queensland, the state's monopoly insurer outside self-insurers, has introduced further return to work measures it successfully uses both internally and externally.

scholarly journals Functional outcomes and quality of life after a 6-month early intervention program for oral cancer survivors: a single-arm clinical trial

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4419 ◽  
Author(s):  
Yueh-Hsia Chen ◽  
Wei-An Liang ◽  
Chung-Yin Hsu ◽  
Siang-Lan Guo ◽  
Shwu-Huei Lien ◽  
...  
Keyword(s):  
Early Intervention ◽  
Oral Cancer ◽  
Return To Work ◽  
Cancer Survivors ◽  
Reconstructive Surgery ◽  
Intervention Program ◽  
Work Rate ◽  
Dash Score ◽  
Early Intervention Program

Background Advanced treatment of oral cancer increases survival rates; however, it also increases the risk of developing shoulder dysfunction, dysphagia, oral dysfunction, donor site morbidity and psychological issues. This single-arm preliminary pilot study aims to explore the effects of a six-month early intervention program following reconstructive surgery in oral cancer survivors. Methods A total of 65 participants were analyzed following reconstructive surgery. Outcome measurements were taken during the first visit, and at one, three and six months after reconstructive surgery. Results Scapular muscle strength and shoulder range of motion progressively improved during the 6-month follow-up. The mean Disability of the Arms, Shoulder and Hand (DASH) score showed significant improvement at 1 month (p < .001). Health related QoL showed significant differences between baseline and 6-months post-surgery scores on global health and on most of the function and symptom scales. The predicted return-to-work rate was 80% at one year after the operation. Return-to-work rate differs in different vocational types, with a higher rate of return in the skilled or semi-skilled (87.5%) and self-employed (86.7%). Conclusions We suggest that early integrated intervention program with a follow-up of at least six months following reconstructive surgery may help develop and identify intervention guidelines and goals in the initial six months of treatment following neck dissection in oral cancer survivors.

A Consultative Rehabilitation Approach in Industry

1986 ◽  
Vol 17 (3) ◽  
pp. 28-32
Author(s):  
Karen O'Malley ◽  
Howard Donaldson
Keyword(s):  
Return To Work ◽  
Cost Containment ◽  
Rate Increase ◽  
Work Rate ◽  
Injured Workers ◽  
Preliminary Evaluation ◽  
Rehabilitation Process ◽  
Disability Compensation

In 1982, amendments to the Michigan Worker’s Disability Compensation Act mandated a substantial increase in the maximum weekly benefit rate to injured workers (from the 1981 maximum of $210 per week to $307 per week). This rate increase became a focus for cost containment by many state employers. One such employer, Motor Wheel Corporation-Lansing Plant, decided to utilize external rehabilitation consultants to facilitate a higher return to work rate of injured workers to lessen compensation expenditures. This article describes the development and preliminary evaluation of the rehabilitation process within Motor Wheel-Lansing Plant.

5-Jahres-Follow-Up der multizentrischen Evaluationsstudie zur medizinisch-beruflichen Rehabilitation (MEmbeR)

2017 ◽  
Vol 56 (05) ◽  
pp. 328-336
Author(s):  
S. Schmidt ◽  
M. Boltzmann ◽  
M. Brunotte ◽  
M. Sailer ◽  
J. Kiesel ◽  
...  
Keyword(s):  
Return To Work ◽  
Work Rate ◽  
Berufliche Rehabilitation ◽  
Berufliche Wiedereingliederung

Zusammenfassung Die medizinisch-berufliche Rehabilitation (mbR) stellt in Deutschland ein Bindeglied zwischen medizinischer und beruflicher Rehabilitation dar und hat die berufliche Teilhabe als primäres Ziel. Die aktuelle Studie stellt die berufliche Wiedereingliederungsquote 5 Jahre nach mbR vor und untersucht, welche Faktoren bereits direkt nach der mbR eine langfristige berufliche Wiedereingliederung prognostizieren können. Zur Evaluation der Nachhaltigkeit der mbR wurde ein Follow-Up mit ehemaligen Studienteilnehmern (n=105) der multizentrischen, prospektiven Evaluationsstudie zur medizinisch-beruflichen Rehabilitation (MEmbeR) zur aktuellen beruflichen Situation durchgeführt. 5 Jahre nach mbR konnten immer noch 76% der aktuellen Studienteilnehmer dem ersten Arbeitsmarkt zugeordnet werden. Die Return-to-work-Rate lag bei 57%. Prognostische Langzeitfaktoren für eine erfolgreiche Integration konnten nicht eindeutig ermittelt werden. Ein niedriger Grad der Behinderung, eine uneingeschränkte Gruppenfähigkeit sowie eine uneingeschränkte Urteils- und Entscheidungsfähigkeit könnten jedoch Faktoren darstellen, die sich günstig auf eine Erwerbsprognose auswirken. Der hohe Anteil an Rehabilitanden, die 5 Jahre nach mbR dem ersten Arbeitsmarkt zur Verfügung stehen (76%), spricht für das Konzept der mbR. Zur Abklärung von Einflussfaktoren einer langfristigen beruflichen Wiedereingliederung sind jedoch weitere Studien erforderlich.

Recovery of activity level following total hip arthroplasty in patients less than 60 years of age

2020 ◽  
pp. 112070002091191 ◽  
Author(s):  
Kazuhiro Takeuchi ◽  
Shingo Hashimoto ◽  
Tomoyuki Matsumoto ◽  
Shinya Hayashi ◽  
Koji Takayama ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Return To Work ◽  
Hip Arthroplasty ◽  
Daily Activity ◽  
Work Rate ◽  
Activity Level ◽  
Ucla Activity Score ◽  
Large Femoral Head ◽  
Total Hip

Background: Total hip arthroplasty (THA) is a useful treatment for pain relief and functional improvement. THA indications now include younger, more active patients, with improved implant design and bearing materials. We aimed to investigate daily activity level and return to work after THA, about which limited information is available. Moreover, differences in patient background and clinical parameters including size of femoral head and surgical approach were evaluated. Methods: A multicentre survey was carried out in patients below 60 years, undergoing THA between 2007 and 2012, at least 1 year after surgery. Primary THA patients with osteoarthritis, avascular necrosis, rheumatoid arthritis, hip dysplasia, and no history of postoperative complications were included. The questionnaire included daily activity and occupation levels before and after surgery. University of California, Los Angeles (UCLA) activity score and occupational classification index were defined, and statistical analysis was performed. Results: The mean preoperative UCLA score in 204 patients was 4.55 which improved to 6.17 after surgery. Pre- as well as postoperative UCLA scores in males were significantly higher than that in females. No differences were observed in other parameters. Return to work rate in males was 94.4%; significantly higher than that in females (52.3%). Younger patients with large head THA were more likely to return to work. Conclusions: Most patients showed improved activity levels. Satisfaction levels were higher in young males with large femoral head size. Patients with a higher preoperative work level are expected to have a higher return to work rate.

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