Wiedereingliederung – und dann? Nachhaltigkeitskonflikte um die Rückkehr an den Arbeitsplatz nach psychischer Erkrankung

2021 ◽  
Vol 70 (3) ◽  
pp. 149-166
Author(s):  
Eike Windscheid
Keyword(s):  
Sick Leave ◽  
Return To Work ◽  
Subsequent Development ◽  
Occupational Reintegration ◽  
Psychic Disorders ◽  
Rückkehr An Den Arbeitsplatz ◽  
The Impact ◽  
Return Process ◽  
Local Leaders

Zusammenfassung Bei der Betrachtung betrieblicher Wiedereingliederung wird in der Regel der Prozess des betrieblichen Eingliederungsmanagements (BEM) fokussiert. Unberücksichtigt dabei bleibt häufig, dass Wiedereingliederung auch nachhaltig sein soll. Rückfällen und erneuter Erkrankung Betroffener soll vorgebeugt ­werden. Damit rückt die Zeit nach der Rückkehr an den Arbeitsplatz in den Fokus. Am Beispiel psychischer Erkrankungen wird untersucht, welche potenziell aus Arbeitsunfähigkeit und Rückkehrprozess resultierenden Folgekonflikte die Nachhaltigkeit von BEM bedrohen. Anhand problemzentrierter Interviews mit Betroffenen, KollegInnen sowie Führungskräften wird gezeigt, dass es hierbei um soziale Konflikte geht, die aus konkurrierenden Interessenkonstellationen resultieren. Diese sind zugunsten akzeptierter Lösungen auszutarieren, um den langfristigen Reintegrationserfolg nicht zu gefährden. Abstract: Occupational Reintegration – What Comes Next? Sustainability Conflicts Around Return to Work After Psychic Disorder When it comes to return to the workplace, typically the process of the return itself is focused. However, terms of sustainability are often underexposed. Relapses and newly occurring disorders should be avoided. For this reason, subsequent development at the workplace is important. By taking the example of psychic disorders, this paper examines follow-up conflicts resulting from sick leave and the return-process, which are threatening sustainability demands. Problem-centered interviews with returnees, colleagues, and local leaders show the impact of social conflicts, resulting from competing constellations of interests. To promote sustainable reintegration socially accepted solutions are needed.

scholarly journals Impact of Socioeconomic Status on Return to Work after Acute Ankle Fracture

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Alessandra L. Falk ◽  
Regina Hanstein ◽  
Chaiyaporn Kulsakdinun
Keyword(s):  
Socioeconomic Status ◽  
Return To Work ◽  
Low Socioeconomic Status ◽  
Ankle Fracture ◽  
Low Ses ◽  
Insurance Status ◽  
Low Socioeconomic ◽  
The Impact ◽  
Zip Code

Category: Ankle; Trauma Introduction/Purpose: Socioeconomic status has been recognized throughout the medical literature, both within orthopedics and beyond, as a factor that influences outcomes after surgery, and can result in substandard care. Within the foot and ankle subspecialty, there is limited data regarding socioeconomic status and post-operative outcomes, with the current literature focusing on outcomes for diabetic feet. However, ankle fractures are among the most common fractures encountered by orthopedic surgeons. While a few studies have explored the impact of ankle fractures on employment and disability status, the effect of socioeconomic status on return to work post operatively has not yet been investigated. The purpose of this study was to determine the impact of low socioeconomic status on return to work. Methods: We retrospectively reviewed 592 medical charts of patients with CPT code 27766, 27792, 27814, 27822, 27823, 27827, 27829, 27826, 27828 from 2015-2018. Included were patients >18 yrs of age who sustained an acute ankle fracture, were employed prior to the injury, and with information on return to work after ankle surgery, zip code, race, ethnicity and insurance status. Excluded were patients who were not employed prior to their injury. Socioeconomic status was either defined by insurance status - Medicaid/Medicare, commercial, or workman’s compensation -, or by assessing socioeconomic status (SES) using medial household per capita income by zip code as generated and reported by the US National Census Bureau’s 2013-2017 American Community Survey 5-Year Estimates. The national dataset was divided into quartiles with the lowest quartile defined as low SES. Patients who had income that fell within this income category were classified as low SES. Results: 174 patients were included with an average follow-up of 10.2months. 22/174 (12.6%) patients didn’t return to work post-operatively. Univariate analysis identified non-sedentary work to decrease the likelihood of return to work (HR:0.637; p=0.03). Patients with a low SES were more prevalent in the no return group compared to the return to work group (86% vs 60%; p=0.028). 95% of patients with low SES were a minority compared to 56% with average/high SES (p<0.005). Patients with low SES had a higher BMI (p=0.026), a longer hospitalization (p=0.04) and more wound complications (p=0.032). Insurance type didn’t affect return to work (p=0.158). Patients with workman’s compensation had a longer follow-up time and a longer time to return to work compared to other insurances (p<0.005 for each comparison). Conclusion: Low socioeconomic status based on income, not insurance type, affected return to work after an ankle fracture ORIF. Patients with workman’s compensation took a longer time to return to work compared to other insurance types. These findings warrants the need to consider socioeconomic status when allocating resources to treat these patients.

Long-term sick leave and graded return to work: What do we know about the follow-up effects?

Health Policy ◽  
2016 ◽  
Vol 120 (10) ◽  
pp. 1193-1201 ◽  
Author(s):  
Udo Schneider ◽  
Roland Linder ◽  
Frank Verheyen
Keyword(s):  
Sick Leave ◽  
Return To Work

scholarly journals The Impact of Musculoskeletal Injuries Sustained in Road Traffic Crashes on Work-Related Outcomes: A Systematic Review

2021 ◽  
Vol 18 (21) ◽  
pp. 11504
Author(s):  
Elise M. Gane ◽  
Melanie L. Plinsinga ◽  
Charlotte L. Brakenridge ◽  
Esther J. Smits ◽  
Tammy Aplin ◽  
...  
Keyword(s):  
Sick Leave ◽  
Road Traffic ◽  
Musculoskeletal Injury ◽  
Musculoskeletal Injuries ◽  
Work Outcomes ◽  
Traffic Crashes ◽  
Road Traffic Crashes ◽  
Work Related ◽  
The Impact

Musculoskeletal injuries occur frequently after road traffic crashes (RTCs), and the effect on work participation is not fully understood. The primary aim of this review was to determine the impact of sustaining a musculoskeletal injury during an RTC on the rate of return to work (RTW), sick leave, and other work outcomes. The secondary aim was to determine factors associated with these work-related outcomes. An electronic search of relevant databases to identify observational studies related to work and employment, RTC, and musculoskeletal injuries was conducted. Where possible, outcome data were pooled by follow-up period to answer the primary aim. Fifty-three studies were included in this review, of which 28 were included in meta-analyses. The pooled rate of RTW was 70% at 1 month, 67% at 3 months, 76% at 6 months, 83% at 12 months, and 70% at 24 months. Twenty-seven percent of participants took some sick leave by one month follow-up, 13% by 3 months, 23% by 6 months, 36% by 12 months, and 22% by 24 months. Most of the factors identified as associated with work outcomes were health-related, with some evidence also for sociodemographic factors. While 70% of people with RTC-related musculoskeletal injury RTW shortly after accident, many still have not RTW two years later.

scholarly journals Standardized multimodal intervention for stress-induced exhaustion disorder: an open trial in a clinical setting

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jakob Clason van de Leur ◽  
Monica Buhrman ◽  
Fredrik Åhs ◽  
Alexander Rozental ◽  
Gunilla Brodda Jansen
Keyword(s):  
Clinical Trial ◽  
Adverse Effects ◽  
Sick Leave ◽  
Return To Work ◽  
Clinical Setting ◽  
Developed Countries ◽  
Working Time ◽  
Multimodal Intervention ◽  
Exhaustion Disorder

Abstract Background Long-term sick-leave due to stress-related ill-health is increasing in several economically developed countries. Even though different forms of interventions are administered in regular care for stress-related disorders, such as Stress-induced Exhaustion disorder (SED), the scientific evidence for the effectiveness of such treatments is sparse. The objective of this study was to explore changes in SED-symptoms and return-to-work-rates in a large group of SED-patients participating in a standardized Multimodal intervention (MMI) in a clinical setting. Method This open clinical trial tracked 390 patients who fulfilled the criteria for SED undergoing a 24-week MMI, including return-to-work-strategies. Before inclusion, all patients underwent a multi-professional assessment by a team of licensed physicians, licensed psychologists, and licensed physiotherapists. Self-rated questionnaires were administered before treatment, at treatment-start, mid-treatment, post-treatment, and at 12-month follow-up. Within-group change was evaluated over time with mixed-effects models. Beyond different symptoms, working time, sick-leave compensation, and adverse effects were also measured. Results There were significant improvements in symptoms of SED, burnout, anxiety, depression, and insomnia, with large within-group effect sizes (d = 0.91–1.76), improvements that were maintained at 12-month follow-up. Furthermore, there was a significant increase in quality of life and large improvements in average working time and sick-leave compensation. Some adverse effects were reported, mainly concerning an increase in stress, anxiety, and worry. Conclusion SED-patients participating in this standardized MMI reported large symptom alleviation, increased working time and reduced sick-leave compensation, indicating a beneficial treatment. There were some adverse effects, but no more so than other psychological treatments. This study confirms previous findings that high levels of depression and anxiety decrease to sub-clinical levels during treatment, while symptoms of SED also decline, yet still persists above sub-clinical levels at 12-month follow-up. On the whole, this open clinical trial suggests that a standardized MMI, administered in a clinical setting, improves symptoms and return-to-work rates in a clinically representative SED-population. Trial registration This study was registered on Clinicaltrials.gov 2017.12.02 (Identifier: NCT03360136).

Long-term sick leave and the impact of a graded return-to-work program: evidence from Germany

2015 ◽  
Vol 17 (5) ◽  
pp. 629-643 ◽  
Author(s):  
Udo Schneider ◽  
Roland Linder ◽  
Frank Verheyen
Keyword(s):  
Sick Leave ◽  
Return To Work ◽  
Work Program ◽  
The Impact

scholarly journals Return to Work in Employees on Sick Leave due to Neck or Shoulder Pain: A Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention with One-Year Register-Based Follow-Up

2017 ◽  
Vol 28 (2) ◽  
pp. 346-356 ◽  
Author(s):  
Line Thorndal Moll ◽  
Ole Kudsk Jensen ◽  
Berit Schiøttz-Christensen ◽  
Christina Malmose Stapelfeldt ◽  
David Høyrup Christiansen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Sick Leave ◽  
Return To Work ◽  
Randomized Clinical Trial ◽  
Shoulder Pain ◽  
Brief Intervention ◽  
One Year

scholarly journals Predictors of return to work among women with long-term neck/shoulder and/or back pain: A 1-year prospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260490
Author(s):  
Mamunur Rashid ◽  
Marja-Leena Kristofferzon ◽  
Annika Nilsson
Keyword(s):  
Social Support ◽  
Back Pain ◽  
Sick Leave ◽  
Return To Work ◽  
Social Insurance ◽  
Behavioral Activities ◽  
Study Participants ◽  
Self Administered Questionnaire

Background Sick leave due to musculoskeletal pain, particularly in the neck/shoulders and back, is one of the major public health problems in Western countries such as Sweden. The aim of this study was to identify predictors of return to work (RTW) among women on sick leave due to long-term neck/shoulder and/or back pain. Methods This was a prospective cohort study with a 1-year follow-up. The study participants were recruited from a local Swedish Social Insurance Agency register and had all been on sick leave for ≥ 1 month due to long-term (≥ 3 months) neck/shoulder and/or back pain. Data on predictors and outcome were collected using a self-administered questionnaire. A total of 208 women aged 23–64 years were included at baseline, and 141 responded at the 1-year follow-up. Cluster analyses were performed to identify one predictor from each cluster for use in the regression model. Results At the 1-year follow-up, 94 of the 141 women had RTW and 47 had not. Women who engaged in more coping through increasing behavioral activities (OR: 1.14, 95% CI: 1.03–1.25) and those who more strongly believed they would return to the same work within 6 months (OR: 1.22, 95% CI: 1.10–1.37) had an increased probability of RTW. Receiving more social support outside work (OR: 0.50, 95% CI: 0.28–0.92) decreased the odds of RTW at the 1-year follow-up. Conclusions Behavioral activities, beliefs about returning to the same work, and social support outside work were predictors of RTW at the 1-year follow-up. Healthcare professionals should consider these predictors in their efforts to prevent prolonged sick leave and to promote RTW in this population.

Indirect costs associated with metastatic breast cancer.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 74-74
Author(s):  
Yin Wan ◽  
Xin Gao ◽  
Sonam Mehta ◽  
Zhixiao Wang ◽  
Claudio Faria ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
General Population ◽  
Sick Leave ◽  
Productivity Loss ◽  
Metastatic Breast ◽  
Indirect Costs ◽  
Potential Cost ◽  
The Impact

74 Background: To estimate indirect costs (sick leave [SL]/short-term disability [STDI]) associated with metastatic breast cancer (MBC) compared to early stage breast cancer (EBC)/a general population without cancer (controls). Methods: The MarketScan Health and Productivity Management database (2005-2009) was used. Adult BC patients eligible for employee benefits of sick leave and/or STDI were identified. Difference in SL and STDI days was calculated between MBC patients and their propensity score matched EBC cohort or controls during a 12-month follow-up period. Indirect costs due to SL/ STDI were estimated by multiplying leave days with daily wages (2011 Bureau of Labor Statistics). Generalized linear model was used to examine the impact of MBC on indirect costs and potential cost drivers. Results: A total of 139 MBC/432 EBC/820 controls and 432 MBC/1,552 EBC/4,682 controls were eligible for SL and STDI respectively (not mutually exclusive), with a mean age of 49/51/50 years. After matching by age, payer type, region, index year and comorbidities, no difference was found in SL days between MBC and EBC cohorts. MBC patients had more STDI days and related cost than EBC patients and controls, with higher total indirect costs (SL + STDI). MBC patients also had more SL days/cost than controls (Table). Controlling for covariates, MBC patients incurred 47% more STDI cost vs. EBC patients (p=.009). Older patients (p=.002), non-HMO payers (p<.05), or patients not receiving chemotherapy during follow-up (p<.001) were associated with lower STDI cost. MBC patients also incurred 56% (p=.01) more SL cost and 11.6 times (p<.001) more STDI cost than controls. Conclusions: Productivity loss and associated costs in MBC patients are substantially higher than EBC patients or general population. These findings underscore the economic burden of MBC from US societal perspective. [Table: see text]

scholarly journals The Fact of Return to Work in Cervical Cancer Survivors and the Impact of Survival Rate: An 11-Year Follow-Up Study

2021 ◽  
Vol 18 (20) ◽  
pp. 10703
Author(s):  
Yu-Shan Sun ◽  
Wei-Liang Chen ◽  
Wei-Te Wu ◽  
Chung-Ching Wang
Keyword(s):  
Cervical Cancer ◽  
Return To Work ◽  
Cancer Survivors ◽  
Research Database ◽  
Cox Proportional Hazard ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models ◽  
Returning To Work ◽  
The Impact

The aim of the current cohort study was to explore the relationship between return to work (RTW) after cervical cancer treatment and different medical and occupational covariates. We also investigated the effect of RTW on all-cause mortality and survival outcomes of cervical cancer survivors. Data were collected between 2004 and 2015 from the database of the Taiwan Cancer Registry, Labor Insurance Database, and National Health Insurance Research Database. The associations between independent variables and RTW were analyzed by Cox proportional hazard models. A total of 4945 workers (82.3%) who returned to work within 5 years after being diagnosed with cervical cancer. Patients who underwent surgical treatment were more likely to RTW by the 5th year compared to other groups, with a hazard ratio (HR) of 1.21 (95% CI: 1.01~1.44). Small company size and a monthly income greater than NT 38,200 were inversely associated with RTW (HR = 0.91, 95% CI: 0.84~0.98 and HR = 0.48, 95% CI: 0.44~0.53). Furthermore, RTW showed a statistically significant decrease in the risk of all-cause mortality in the fully adjusted HR, (HR = 0.42, p < 0.001). Some medical and occupational factors are associated with RTW in cervical cancer survivors. Returning to work may have a beneficial effect on the survival of patients with cervical cancer.

scholarly journals Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with depression or anxiety: results from a three-arm, parallel randomised trial

2021 ◽  
pp. oemed-2021-107894
Author(s):  
Andreas Hoff ◽  
Rie Mandrup Poulsen ◽  
Jonas Fisker ◽  
Carsten Hjorthøj ◽  
Nicole Rosenberg ◽  
...  
Keyword(s):  
Sick Leave ◽  
Return To Work ◽  
Vocational Rehabilitation ◽  
Primary Outcome ◽  
Randomised Trial ◽  
Mental Healthcare ◽  
Stress Symptoms ◽  
Registration Number ◽  
Anxiety Depression

ObjectiveThe aim of this study was to investigate an integrated mental healthcare and vocational rehabilitation intervention to improve and hasten the process of return-to-work of people on sick leave with anxiety and depression.MethodsIn this three-arm, randomised trial, participants were assigned to (1) integrated intervention (INT), (2) improved mental healthcare (MHC) or (3) service as usual (SAU). The primary outcome was time to return-to-work measured at 12-month follow-up. The secondary outcomes were time to return-to-work measured at 6-month follow-up; levels of anxiety, depression, stress symptoms, and social and occupational functioning at 6 months; and return-to-work measured as proportion in work at 12 months.Results631 individuals were randomised. INT yielded a higher proportion in work compared with both MHC (56.2% vs 43.7%, p=0.012) and SAU (56.2% vs 45%, p=0.029) at 12-month follow-up. We found no differences in return-to-work in terms of sick leave duration at either 6-month or 12-month follow-up, with the latter being the primary outcome. No differences in anxiety, depression or functioning between INT, MHC and SAU were identified, but INT and MHC showed lower scores on Cohen’s Perceived Stress Scale compared with SAU at 12-month follow-up.ConclusionsAlthough INT did not hasten the process of return-to-work, it yielded better outcome with regard to proportion in work compared with MHC and SAU. The findings suggest that INT compared with SAU is associated with a few, minor health benefits. Overall, INT yielded slightly better vocational and health outcomes, but the clinical significance of the health advantage is questionable.Trial registration numberNCT02872051.

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