Implementation of a Return to Work Strategy in Germany—Are There Changes in Work-Related Rehabilitation Measures and Employment Status in Chronic Conditions?

Cornelia Gerdau-Heitmann,Monika Schwarze

doi:10.4236/ojtr.2016.41005

Cornelia Gerdau-Heitmann, Monika Schwarze

Open Access

https://doi.org/10.4236/ojtr.2016.41005

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Abstract

Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants with chronic conditions. The objective was to identify the degree of implementation of work related measures in medical rehabilitation and the extent of RTW outcomes. Methods: 5883 insurants were considered. Severe Restriction of Work Ability (SRWA), Work-related Medical Rehabilitation (WMR), and Case Management (CM) were examined for 2008 and 2012. An Index of Employment status (IoE) was used in a logistic regression. Results: Utilization of WMR raised from 12.3% in 2008 to 66.1% in 2012. The proportion of insurants with SRWA and WMR grew from 8% up to 40.1%. In 2008, 14.7% of insurants with SRWA received WMR; in 2012, it grew to 76.6%. On the other hand, in 2012 26% got WMR without SRWA and 12.2% had SRWA and got no WMR. CM was not conducted in 2008 but reached 20.2% in 2012. Across all indications, WMR resulted in positive RTW as measured by IoE: OR = 0.75 (KI-95%: 0.67 - 0.86). Conclusion: WMR was successfully implemented according to the German guideline. There is a need to optimize the linkage between SRWA and WMR and CM to provide need-based care.

Highlights

Due to demographic changes—like those in many industrialized societies—Germany is facing a reduction and aging of the population [1] [2]
Work-related Medical Rehabilitation (WMR) was successfully implemented according to the German guideline
There is a need to optimize the linkage between Severe Restriction of Work Ability (SRWA) and WMR and Case Management (CM) to provide need-based care

Summary

Introduction

Due to demographic changes—like those in many industrialized societies—Germany is facing a reduction and aging of the population [1] [2]. These population changes cause a rising prevalence of chronic conditions [3] [4]. They impact the labor market, where companies are encountering massive challenges because of the moving age composition of the workforce [5] [6]. In regard to sick leave, chronic conditions often lead to high numbers and long duration. The numbers of people on sick leave for MSD are continually at a high level. Early retirement due to the incapacity to work is rising, for people with psychosomatic disorders [12]

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