BackgroundThis study assessed the psychosocial determinants as explanatory variables for the length of the work disability period. The aim was to estimate the predictive value of a selected set of psychosocial determinants from the Quickscan questionnaire for the length of the sick leave period. A comparison was also made with the most common biomedical determinant: diagnosis.MethodsIn a cohort study of 4 981 insured Belgian patients, the length of the sick leave was calculated using Kaplan–Meier. Predictive psychosocial determinants were selected using backward conditional selection in Cox regression and using concordance index values (C-index) we compared the predictive value of the biomedical to the psychosocial model in a sample subset.ResultsFourteen psychosocial determinants were significantly (p<0.10) related to the length of the sick leave: health perception of the patient, physical workload, social support management, social support colleagues, work–health interference, psychological distress, fear of colleagues’ expectations, stressful life-events, autonomy, learning and development opportunities, job satisfaction, workload, work expectations and expectation to return to work. The C-index of this biopsychosocial model including gender, age and labour status was 0.80 (CI: 0.78; 0.81) (n=4 981). In the subset of 2 868 respondents with diagnostic information, the C-index for the same model was .73 (CI: 0.71; 0.76) compared with 0.63 (CI: 0.61; 0.65) for the biomedical model.ConclusionsA set of 14 psychosocial determinants showed good predictive capacity (C-index: 0.80). Also, in a subset of the sample, the selected determinants performed better compared with diagnostic information to predict long-term sick leave (>6 months).

The way in which retirement is conceptualized and measured is likely to influence the research findings. The previous literature has addressed a wide range of elements related to the complex work-to-retirement process, such as early, late and partial retirement, statutory retirement, work disability and unemployment paths to retirement, or different types of bridge employment. However, conceptual clarity in terms of connections between the different elements is called for. We introduce a conceptual framework of the work-to-retirement process to guide its future measurement. Together with information on the statutory retirement age, the main elements of the framework are based on employment and pension receipt, acknowledging that these may overlap. The framework is flexible to the user, providing the possibility to add various specifications—e.g. of types of employment, types of pension receipt, unemployment, and being outside the labour force—depending on the study context and aims. The framework highlights the complexity of the work-to-retirement process, bringing forth its multifaceted, multiphased and multidirectional features. Accounting for such complexity in later-life labour market dynamics helps to elaborate what is actually addressed when investigating “retirement”. Our conceptual framework can be utilized to enhance well-defined, precise and comparable measurement of the work-to-retirement process in studies.

No abstract

Purpose: To reduce long-term absenteeism, several countries take legislative initiatives. In this study, we evaluate the impact of a legally defined return-to-work (RTW) trajectory on the RTW of sick-listed employees.Methods: We conducted a retrospective registered-based cohort study on Belgian employees (N = 1416) who followed a RTW-trajectory in 2017. We linked workers’ data from a Service for Prevention and Protection at Work with data from the Crossroads Bank for Social Security. We analysed how many employees RTW with the same employer, with another employer or not at all. By multinomial logistic regression, we analysed which characteristics are predictive for RTW.Results: One year after their trajectory, 69.2% of employees did not RTW, 10.7% did RTW with the same employer, 20.1% did RTW with a new employer. Duration of sickness absence (SA) was an important predictor for both RTW with the same as with another employer. When duration of SA exceeded six months, odds of RTW were lower than when the duration of SA was < six months. Marital status, organization-size, and decision of occupational physician had significant impact on RTW with the same employer, while age and who initiated the trajectory were key factors for RTW with another employer. Conclusions: 30.8% of employees succeeded to RTW after their trajectory. Results show that a one-size-fits-all-approach is not recommended. A stepped approach with an early, informal start of the RTW-process should be implemented. When employees or employers fail to initiate RTW on their own, a legally defined RTW-trajectory could be useful.

No abstract