Presentation M O27
M O27 (Oral Presentation):
Predictors of functional improvement and future work status after the disability benefit claim: a prospective cohort study
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen
- Research Center for Insurance Medicine
- Social Security Institute
- Department of Health Sciences, VU University, Amsterdam
In an effort to reduce inflow into disability benefit schemes, several European countries have changed disability benefit policies in recent years, emphasizing re-entry into the workforce and participation of the disabled worker, rather than financial compensation by cash benefit. The present prognostic study is the first to specifically focus on the period after the claim aiming to investigate which factors predict functional improvement and future work status among persons claiming disability benefit after having been on long-term sickness leave.
Prospective cohort study with one year follow-up among disability claimants (n=375; response rate: 24.3%) conducted in the Netherlands (October 2008 to April 2011). Logistic regression was used to analyze associations between predictors (demographics; outcomes of the 12-item General Health Questionnaire (GHQ-12); 10-item Kessler Psychological Distress scale; Alcohol Use Disorders Identification Test; Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness; Utrecht Coping List; Social Support Questionnaire for Transactions and Satisfaction; certified diagnosis International Classification of Diseases, 10th revision (ICD-10); Loss of Earning Capacity (LEC)) and outcomes (functional improvement on the World Health Organization Disability Schedule 2.0 (WHODAS 2.0) exceeding the standard error of measurement; work status at follow-up).
Functional improvement on total WHODAS was reported in 31.9% of cases. Of those not having work at baseline, 9.1% had paid work at follow-up. Of respondents both having no paid work at baseline and reporting substantial functional improvement, 10.6% had paid work at follow-up. Predictors of functional improvement: GHQ-12 sum score>20 (OR 2.9; 95% CI=1.54-5.34); predictors of future work status: work status at baseline (OR 16.8; 95% CI=6.55-43.14), LEC<80% (OR 4.6; 95%=CI 1.87-11.42), contact with a medical specialist (OR 0.4; 95%=CI 0.19-0.87).
Despite substantial functional improvement, only few respondents have paid work after one year follow-up. A limited number of factors were found to significantly predict functional improvement and return to paid work after the disability benefit claim, having paid work at baseline being by far the most important factor
Monday September 29
15:45 - 17:15 Afternoon Concurrent Sessions (M O25 - M O37 and Seminar 3)
Session: Long-term work disability