The Impact of Diagnosis on Job Retention: A Danish Registry-Based Cohort Study

Abstract

Background. In 1998, Denmark introduced the flex job scheme to ensure employment of people with a permanent reduced work capacity. This study investigated the association between select diagnoses and the risk of disability pension among persons eligible for the scheme. Methods. Using the national DREAM database we identified all persons eligible for the flex job scheme from 2001 to 2008. This information piece was linked to the hospital discharge registry. Selected participants were followed for 5 years. Results. From the 72,629 persons identified, our study included 329 patients with rheumatoid arthritis, 10,120 patients with spine disorders, 2179 patients with ischemic heart disease, and 1765 patients with functional disorders. A reduced risk of disability pension was found in the group with rheumatoid arthritis (hazard ratio = 0.69 (0.53–0.90)) compared to the group with spine disorders. No differences were found when comparing ischemic heart disease and functional disorders. Employment during the first 3 months of the flex job scheme increased the degree of employment for all groups. Conclusion. Differences in the risk of disability pension were identified only in patients with rheumatoid arthritis. This study demonstrates the importance of obtaining employment immediately after allocation to the flex job scheme, regardless of diagnosis.

Methodological aspects of design, analysis and reporting of studies with work participation as an outcome domain in patients with inflammatory arthritis: results of two systematic literature reviews informing EULAR points to consider

“…Twenty-three studies on costs of WP were cross-sectional or retrospective and therefore did not comply with inclusion criteria to assess general methodological choices. A total of 81 studies were included in our analysis (flowchart in online supplemental figure S2): 58 for extraction of general methodological choices,16–73 23 for outcome reporting studies on costs of work productivity16 74–96 and one providing information on both outcomes 16…”

“…The 58 IA studies appraising general methodological issues comprised 46 longitudinal observational studies16 17 20 23 26 27 29–31 33 34 39–47 50 51 55–59 61 63 65 66 68 70–73 and 22 RCTs 18 19 21 22 24 25 28 32 35–38 48 49 52–54 60 62 64 67 69. The characteristics of included studies are provided in online supplemental table S1.…”

“…Most of the IA studies were on rheumatoid arthritis (RA) (n=33, 57%),16 17 21–24 27–29 31–34 36 37 39–41 44–47 49 52–54 56 57 61 64 68 69 72 followed by axial spondyloarthritis (axSpA) (n=16, 28%)18 19 30 38 50 51 59 60 62 63 65–67 70 71 73 and psoriatic arthritis (PsA) (n=6, 10%),25 35 43 48 55 58 and finally, two studies assessed two diagnostic groups: RA and axSpA,42 and axSpA and PsA 26…”

“…The type of intervention and WP outcome domain for each study is presented in online supplemental table S1, and the corresponding data grouped by type of study (RCTs vs longitudinal observational studies) is shown in online supplemental table S2. Work was assessed as a primary outcome in only 26/58 (45%) of the studies,16 17 21 23 26 27 29–31 41 42 44–47 50 56–58 61 63 64 66 68 71 rarely being the primary outcome in RCTs (n=2/22, 9%) 21 64. The time horizon for the assessment of WP outcomes varied from 24 weeks to 12 years and its distribution, as well as the frequency of assessment by work outcome domain, are both provided in online supplemental table S3.…”

“…Table 1 provides an overview of methodological choices in the area of study design . The included population was aligned with the specific work-related study objective in only 16/58 (28%) IA studies,21–23 26 27 30 31 43–46 50 61 63 64 66 while the sample size calculation was performed solely in 8 (14%) studies 21 30 42 44 56 58 64 68…”