gms | German Medical Science

Background: Rehabilitation on behalf of the German pension insurance has to prevent work disability pension (WDP). In the medical rehab-discharge report, a rating of the work-capacity after rehab is documented.

Aim: The aim of our study was to analyze whether this can predict the claim for WDP after medical rehabilitation.

Method: The analysis included all medical rehabilitation measures due to musculoskeletal diseases. We used routine data of the GPI including the information of the rehab-discharge report and the work trajectories six years prior to and five years after rehabilitation. The work capacity was documented in three categories: more than 6 hours, 3 to 6 hours and less than 3 yours per day. To test the predictive validity of the daily work capacity, multiple regression models were calculated. The models were adjusted for sick leave in the year before rehabilitation, days in paid employment six years before rehabilitation and age.

Results/findings: We included data of 93,783 patients (48±8 years). Of all patients, 1,027 (1.1%) had a documented work capacity of 3 to 6 hrs per day and 481 (0.5%) were evaluated with less than 3 hrs. In the 5-year-follow-up, 10,473 persons (11.2%) received a WDP. A reduced work capacity per day in the rehab led to a significantly higher chance of WDP (3 to 6 hrs: OR=9.23; less than 3 hrs: OR=15.28). However, only 972 of all 10,473 WDP patients could be identified (9.3%).

Discussion and conclusions: The documented work capacity in the rehab is strongly associated to the access to early retirement due to permanent work disability in the 5-year-follow-up. But compared to the WDP access rates, the proportion of patients with reduced work capacity per day in the rehab was low. The results underline the multi-complex, hardly predictable transition from active work to early retirement.