Factors associated with returning to work after long term absence due to mental disorders

AbstractIf there is a chance for a person’s ability to work to be restored through treatment or rehabilitation, a temporary disability pension may be granted in Finland. We examined the personal, socio-economic and healthcare-related factors associated with return to work (RTW) after the receipt of temporary disability pension. The study material contains comprehensive register data of individuals who were granted a temporary disability pension due to a mental disorder (ICD10: F10–F69, F80–F99) for the first time between 2010 and 2012 (N = 8615). We applied clustering analysis in order to reveal different patterns of returning to work after receipt of temporary disability pension and utilized multinominal regression analysis to examine gender-specific determinants for RTW and partial RTW in a controlled setting. Being a lower-grade employee remarkably promoted RTW for women (OR 7.85 95% CI 5.35–11.51), as did being a manual worker for men (OR 5.47 95% CI 3.48–8.78). Moreover, both active male (OR 3.51 95% CI 2.19–5.61) and female manual workers (OR 2.44 95% CI 1.66–3.59) had a higher probability of partial RTW compared to people who were initially unemployed. In addition, psychotherapy and vocational rehabilitation were associated with an increased probability of RTW. After 3 years from the initial temporary pensioning, almost two-thirds of the study population (69% of men and 64% of women) still had a temporary or by then a permanent disability pension due to a mental disorder. This and further research could improve the ability to recognize those subjects more likely to return to work than others.

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The importance of clinical and labour market histories in psychiatric disability retirement: analysis of the comprehensive Finnish national-level RETIRE data

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-019-01815-6 ◽

2019 ◽

Vol 55 (8) ◽

pp. 1011-1020 ◽

Cited By ~ 1

Author(s):

S. Pirkola ◽

J. Nevalainen ◽

M. Laaksonen ◽

S. Fröjd ◽

K. Nurmela ◽

...

Keyword(s):

Mental Disorders ◽

Labour Market ◽

Work Ability ◽

Disability Pension ◽

National Level ◽

Psychiatric Disability ◽

Permanent Disability ◽

Returning To Work ◽

Age And Sex

Abstract Objectives Despite the stable incidence of mental disorders in Finland and Europe, mental health-related occupational disability has been increasing. We unveiled the paths to permanent psychiatric disability, recovery, or death, by analysing sequences of labour market participation. Methods The RETIRE register database includes information regarding all persons (n = 42,170) awarded an ICD-10 psychiatric disability pension between 2010 and 2015 in Finland. We identified clusters of typical paths of pre-retirement labour market history. Controlling for major mental disorders, age, and sex, we evaluated factors associated with returning to work (RTW), or death, over a 5-year follow-up period. Results Only 10.5% of the disabled subjects returned to work within the follow-up. Half of them ended up with a permanent disability pension. Seven distinguishable paths to disability were identified. Subjects in the cluster characterized by steady employment were relatively often females, lost their work ability due to affective disorders, and had the highest rate of returning to work (16.3%). Mortality was highest (9%) among the cluster characterized by long-term unemployment. Distributions of major diagnostic groups, as well as age and sex, differed between clusters. After their adjustment in the analysis of RTW or death, the identified labour market history paths prior to losing work ability remained as important independent prognostic factors for both outcomes. Conclusions The complex retirement process involves identifiable clinical and contextual associating factors. Labour market history patterns associate with varying prognoses after psychiatric retirement. Prolonged unemployment appears as a predictor of relatively poor prognoses, whereas employment indicates the opposite.

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Time to surgery (TTS) in renal cell carcinoma (RCC): Predictors and association with overall survival (OS).

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e16107 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e16107-e16107

Author(s):

Anuhya Kommalapati ◽

Sri Harsha Tella ◽

Pavankumar Tandra

Keyword(s):

Surgical Resection ◽

Primary Tumor ◽

Private Insurance ◽

Preoperative Evaluation ◽

Time Frame ◽

Lower Grade ◽

Related Factors ◽

Cancer Data ◽

Factors Associated ◽

Risk Of Death

e16107 Background: Guidelines recommend surgical resection of primary tumor in stages 1-3 RCC. TTS refers to the time frame from the initial diagnosis to surgical resection of primary tumor. Shorter TTS has shown OS benefit in breast, head and neck cancers whereas longer TSS was shown to be acceptable in colon cancer. However, no such data exists for RCC. Using National Cancer Data Base (NCDB), we sought to determine the factors associated with TTS and its effect on OS. Methods: Patients with RCC who underwent partial or total nephrectomy were included, excluding those received neoadjuvant therapy. Logistic regression model was utilized to evaluate relative risk of delayed TTS. OS in association with TTS was estimated using the Kaplan-Meier method and Cox multivariate analysis (MVA). Results: A total of 60,198 RCC patients met the inclusion criteria. In contrast to a prior study that showed a median TTS of 41 days our study showed a median TTS of 35 days. We dichotomized the TTS as ≤ 35 days or ≥ 36 days. On MVA, TSS ≥ 36 days had significantly better OS (HR: 0.95 [CI:0.92-0.99], p < 0.01). Factors associated with TSS ≥ 36 days were race, insurance, higher Charlson score, lower grade, and getting managed at academic facilities and Pacific region (p < 0.01) (Table). Conclusions: A longer TTS with RCC is understandably associated with greater comorbidity, and non-private insurance, but questionably so in race, ethnicity, and facility related factors. However, given that TTS ≥ 36 days was not associated with higher risk of death, it may indicate that a reasonable delay could be pursued in certain cases for more accurate preoperative evaluation. [Table: see text]

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Successful Return to Work for Cancer Survivors

AAOHN Journal ◽

10.1177/216507990705500705 ◽

2007 ◽

Vol 55 (7) ◽

pp. 290-295 ◽

Cited By ~ 55

Author(s):

Nancy M. Nachreiner ◽

Rada K. Dagher ◽

Patricia M. McGovern ◽

Beth A. Baker ◽

Bruce H. Alexander ◽

...

Keyword(s):

Return To Work ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Critical Role ◽

Recovery Process ◽

Population Based ◽

Related Factors ◽

Returning To Work ◽

Female Cancer Survivors

This study investigated factors associated with successful return to work for cancer survivors in accordance with the Americans with Disabilities Act. A focus group was held with seven female cancer survivors. Participants discussed return-to-work issues following a cancer diagnosis. Factors such as coworker support and job flexibility improved their experiences, whereas coworker and supervisor ignorance about cancer and lack of support made returning to work more stressful. Participants discussed personal, environmental, and cancer-related factors that influenced their experiences with returning to work following a cancer diagnosis. Knowledge of factors that support employees helps occupational health nurses ease their transition, and may improve quality of life for employees. Physicians and health care provider teams may play a critical role in the employees' positive evaluation of their recovery process. This pilot study serves as a basis for a larger, population-based study.

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Factors Associated with Return to Work Postinjury: Can the Modified Rankin Scale be Used to Predict Return to Work?

The American Surgeon ◽

10.1177/000313481608200210 ◽

2016 ◽

Vol 82 (2) ◽

pp. 95-101 ◽

Cited By ~ 3

Author(s):

Anirudh Kohli ◽

Edward Chao ◽

Daniel Spielman ◽

Dordaneh Sugano ◽

Abhishek Srivastava ◽

...

Keyword(s):

Return To Work ◽

Odds Ratio ◽

Employment Status ◽

Trauma Registry ◽

Telephone Interview ◽

Modified Rankin Scale ◽

Inclusion Criteria ◽

Factors Associated ◽

Trauma Population ◽

Returning To Work

The ability to return to work (RTW) postinjury is one of the primary goals of rehabilitation. The modified Rankin Scale (mRS) is a validated simple scale used to assess the functional status of stroke patients during rehabilitation. We sought to determine the applicability of mRS in predicting RTW postinjury in a general trauma population. The trauma registry was queried for patients, aged 18 to 65 years, discharged from 2012 to 2013. A telephone interview for each patient included questions about employment status and physical ability to determine the mRS. Patients who had RTW postinjury were compared with those who had not (nRTW). Two hundred and thirty-four patients met the inclusion criteria. Of these, 171 (72.5%) patients RTW and 63 (26.7%) did nRTW. Patients who did nRTW were significantly older, had longer length of stay and higher rates of in-hospital complications. Multivariate analysis revealed that older patients were less likely to RTW (odds ratio = 0.961, P = 0.011) and patients with a modified Rankin score ≤2 were 15 times more likely to RTW (odds ratio = 14.932, P < 0.001). In conclusion, an mRS ≤2 was independently associated with a high likelihood of returning to work postinjury. This is the first study that shows applicability of the mRS for predicting RTW postinjury in a trauma population.

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Mortality among Male Disability Pensioners

Scandinavian Journal of Social Medicine ◽

10.1177/140349487700500204 ◽

1977 ◽

Vol 5 (2) ◽

pp. 73-75 ◽

Cited By ~ 5

Author(s):

Asbjörn Medhus ◽

Hans Kristenson

Keyword(s):

Respiratory System ◽

Disability Pension ◽

Causes Of Death ◽

Circulatory System ◽

Basic Material ◽

Post Mortem ◽

Permanent Disability ◽

Common Causes ◽

Expected Mortality ◽

First Time

The basic material consists of all 235 men who were granted temporary or permanent disability pension in Malmö for the first time in 1964. By the end of 1974, 111 had died; the expected mortality was 42. The most common causes of death were diseases of the circulatory system, neoplasms, and diseases of the respiratory system. The post-mortem diagnoses of the 111 deceased usually agreed with the main diagnoses at the time of the pension award.

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Functionality and factors associated with work behaviour among Brazilian breast cancer survivors: A cross-sectional study

Work ◽

10.3233/wor-203342 ◽

2020 ◽

Vol 67 (4) ◽

pp. 917-925

Author(s):

Kamilla Zomkowski ◽

Anke Bergmann ◽

Cinara Sacomori ◽

Mirella Dias ◽

Fabiana Flores Sperandio

Keyword(s):

Breast Cancer ◽

Return To Work ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Cross Sectional Study ◽

Upper Limbs ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Returning To Work

BACKGROUND: Breast cancer treatments lead to several comorbidities in the upper limbs, such as pain and stiffness, hindering physical functions and the return to work. OBJECTIVE: To explore the functionality and factors associated with work behaviour among manual and non-manual Brazilian workers who have recovered from breast cancer. METHODS: This is an observational cross-sectional study involving Brazilian breast cancer survivors. The sociodemographic, work, and clinical aspects were assessed through clinical records, upper limb disability, and human functionality obtained from 62 women. Multiple and univariate logistic regressions were used to identify the association of variables on return to work, p < 0.05. RESULTS: 56.5% of women did not return to work, the mean time for returning to work was 16 months (±15.21), absenteeism from work lasted 41 months (±34.58). Modified radical mastectomy (OR = 5.13, 95% CI = 1.35 to 18.66) and moderate-to-severe disability levels in the upper limbs (OR = 6.77, 95% CI = 1.86 to 24.92) were associated with not returning to work. The loss of productivity was higher among non-manual workers (21.5%) (p = 0.040). CONCLUSIONS: The rates of not returning to work after breast cancer treatment are high. Women who did not return to work presented higher levels of disability.

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Abstract 17031: Incidence of Life-Threatening Events in Children With Wolff-Parkinson-White Syndrome

Circulation ◽

10.1161/circ.138.suppl_1.17031 ◽

2018 ◽

Vol 138 (Suppl_1) ◽

Author(s):

Christopher M Janson ◽

Marisa E Millenson ◽

Dingwei Dai ◽

Reina Bianca Tan ◽

V. Ramesh Iyer ◽

...

Keyword(s):

Independent Predictor ◽

Population Level ◽

Administrative Claims ◽

White Syndrome ◽

Factors Associated ◽

Life Threatening ◽

Study Population ◽

First Time ◽

Wolff Parkinson White Syndrome

Introduction: Life-threatening events (LTE) in patients with Wolff-Parkinson-White Syndrome (WPW) are rare, with considerable variation in published rates. Existing data on LTE incidence represent selected populations or tertiary referral-based cohorts. Access to large observational datasets allows, for the first time, measurement of the risk of LTE in an unselected, contemporary WPW population. Methods: A retrospective cohort study was conducted using administrative claims from Truven Health Analytics (MarketScan ® ) to identify all WPW patients (aged ≤18 years) from both inpatient and outpatient encounters between January 2013 and December 2016. Prevalence of WPW was measured. A composite outcome, LTE, was defined as an episode that included ventricular fibrillation or cardiac arrest. Secondary outcomes included diagnoses of atrial fibrillation (AF) and supraventricular tachycardia (SVT). Factors associated with LTE were evaluated by creating multivariable models. Results: The prevalence of WPW in the study population was 0.025% (4,717/18,884,579). Subjects with WPW were 57% male, had a median age of 13 yrs (IQR 7-16 yrs), with coincident Ebstein’s anomaly in 1.9%, other congenital heart disease (CHD) in 12%, and cardiomyopathy (CM) in 2%. Over the study period, SVT was reported in 20.3% (n=957/4,717), and AF in 1.3% (n=61/4,717) of subjects. Patients with AF were 79% male (n=48/61), with median age 16 yrs (IQR 14-17 yrs), with CHD in 25% (n=15/61) and CM in 7% (n=4/61). LTE occurred in 23 subjects: 70% male (n=16/23), at median age 16 yrs (IQR 7-17 yrs), with CHD in 9% (n=2/23) and CM in 13% (n=3/23); AF was reported in 3 patients with LTE. The incidence of LTE was 1.4 events per 1000 person years of follow up (23/16,514). In a multivariate model including age, gender, CHD, and CM, the only independent predictor of LTE was CM (OR 10.2, 95% CI 2.4-31.1, p<0.001). Conclusions: Use of a large claims dataset allowed for evaluation of LTE risk in an unselected pediatric WPW population. This WPW-related LTE estimate of 1.4/1000 person years can serve as a benchmark for assessment of risk reduction interventions on a population level. Incidence of LTE in this unselected contemporary cohort is consistent with observed rates in prior reports from selected populations.

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Work Resumption after a Fixed-Term Disability Pension: Changes over Time during a Period of Decreasing Incidence of Disability Retirement

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094618 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4618

Author(s):

Mikko Laaksonen

Keyword(s):

Return To Work ◽

Disability Pension ◽

Age Groups ◽

Drop Out ◽

Permanent Disability ◽

Disability Retirement ◽

Occupational Characteristics ◽

Somatic Diseases ◽

Changes Over Time ◽

Work Resumption

The incidence of disability retirement in Finland has sharply decreased over the last ten years. At the same time, the share of fixed-term pensions has increased to cover more than half of all new disability pensions. This study examined the efficiency of fixed-term disability pensions under these changing circumstances with the aim of addressing the following research questions: are fixed-term disability pensions more often converted to permanent pensions, and how have the changes affected return to work? The study was based on register data of Finnish residents aged 25–62 whose fixed-term disability pension started in 2006 (n = 10,177) or 2015 (n = 7918). Of the fixed-term disability pensions starting in 2006, 58 percent were converted to a permanent disability pension within the next four years. In 2015, the corresponding figure was 41 percent. Return to work increased from 24 to 30 percent. In addition, ending up in some other state (most often unemployment) increased, and, more often, fixed-term disability pensions continued for more than four years. Transferring to a permanent disability pension decreased more among the younger, those with a lower education, and those suffering from mental disorders. The results were not notably affected by changes in the characteristics of fixed-term disability pension recipients (e.g., demographic and occupational characteristics and rehabilitation) or the selection of applicants into a fixed-term or a permanent pension. Return to work increased more among men, the older age groups, those with a fixed-term disability pension due to somatic diseases, and those who had received vocational rehabilitation. Adjusting for the composition of fixed-term disability pensioners increased the differences between the study years, and controlling for the selection into a fixed-term pension further widened the differences. In conclusion, a decreasing proportion of fixed-term disability pensions are converted to permanent pensions, but this is only partly reflected in increased return to work. Further efforts are needed to support work resumption after a fixed-term disability pension to avoid the situation where people drop out from disability pension but are resting on unemployment and other benefits.

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