MBOR-M: Effects on participation of work-related medical rehabilitation at the Mühlenbergklinik

Musculoskeletal disorders are among the most common conditions that lead to work disability. Work-related medical rehabilitation is a multimodal interdisciplinary approach to reduce health-related discrepancies between work capacity and job demands in order to achieve work participation, especially for patients with severely more restricted work ability. The study tested the effects of a work-related medical rehabilitation program, implemented in routine care, compared with common medical rehabilitation in patients with musculoskeletal disorders.
To answer the research question, data from questionnaires were linked with administrative data from the German Pension Insurance North. Data were assessed in 2014 and 2015 and were analyzed by an as-treated analysis. Participants were assigned to work-related medical rehabilitation if they had received at least9.5 hours of work-oriented therapeutic services, as recommended in the requirement profile for conducting work-related medical rehabilitation. By means of propensity-score-matching, participants of work-related medical rehabilitation (intervention group) were compared with similar participants of common medical rehabilitation (control group). The primary outcome was a positive work status one year after discharge of rehabilitation. Secondary outcome measures were the receipt of unemployment benefits or sickness benefits and disability pension one year after the end of rehabilitation. Treatment effects were analyzed by logistic regressions and absolute risk reductions were calculated.

312 patients (156 in the intervention group) were included in the analysis one year after rehabilitation. Propensity-score-matching achieved balanced sample characteristics. Work-related medical rehabilitation increased a positive work status by 11 points compared to common medical rehabilitation. For the other secondary outcome measures, no benefit was observed in favor of the intervention group.
The work-related medical rehabilitation program implemented in routine care led to higher employment rates after one year compared to conventional medical rehabilitation.