[Promotion of Work Participation in Outpatient vs. Inpatient Work-Related Medical Rehabilitation (WMR) in Patients with Musculoskeletal Disorders: Analyses Using Administrative Data].

Abstract

The aim of the present study was to compare outpatient vs. inpatient work-related medical rehabilitation (WMR) with regard to treatment dose of work-related interventions and promotion of work participation.The rehabilitation statistics database of the German Pension Insurance was used. Patients were included if they had completed WMR for musculoskeletal disorders in 2018 or 2019 and were aged up to 63 years. The implementation of WMR was measured based on work-related interventions documented in the discharge report.The sample consisted of 46,276 rehabilitants. Work-related interventions were documented with an average total duration of 8.2 (outpatient WMR) and 9.3 (inpatient WMR) hours. In 25.7% of the outpatient and 37.1% of the inpatient rehabilitants, the minimum total duration of 11 hours was met. With regard to the promotion of occupational participation, no significant difference was observed between inpatient and outpatient WMR (OR=0.96, 95% CI [0.90, 1.03], reference: inpatient WMR), suggesting a potentially comparable benefit.The need for WMR measures was not consistently met in either outpatient or inpatient rehabilitation. In both settings, people assigned to WMR predominantly received less work-related interventions than intended. The promotion of return to work was achieved with comparable effectiveness in both outpatient and inpatient WMR.