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Return to work after medical rehabilitation in Germany: influence of individual factors and regional labour market based on administrative data

Author

Listed:
  • Christian Hetzel

    (Institute for Quality Assurance in Prevention and Rehabilitation at the German Sport University in Cologne)

  • Sarah Leinberger

    (Institute for Research in Rehabilitation Medicine at Ulm University)

  • Rainer Kaluscha

    (Institute for Research in Rehabilitation Medicine at Ulm University)

  • Angela Kranzmann

    (Federal German Pension Insurance)

  • Nadine Schmidt

    (Federal German Pension Insurance)

  • Anke Mitschele

    (Federal German Pension Insurance)

Abstract

Background The influence of both individual factors and, in particular, the regional labour market on the return to work after medical rehabilitation is to be analyzed based on comprehensive administrative data from the German Pension Insurance and Employment Agencies. Method For rehabilitation in 2016, pre- and post-rehabilitation employment was determined from German Pension Insurance data for 305,980 patients in 589 orthopaedic rehabilitation departments and 117,386 patients in 202 psychosomatic rehabilitation departments. Labour market data was linked to the district of residence and categorized into 257 labour market regions. RTW was operationalized as the number of employment days in the calendar year after medical rehabilitation. Predictors are individual data (socio-demographics, rehabilitation biography, employment biography) and contextual data (regional unemployment rate, rehabilitation department level: percentage of patients employed before). The estimation method used was fractional logit regression in a cross-classified multilevel model. Results The effect of the regional unemployment rate on RTW is significant yet small. It is even smaller (orthopaedics) or not significant (psychosomatics) when individual employment biographies (i.e., pre-rehabilitation employment status) are inserted into the model as the most important predictors. The interaction with pre-rehabilitation employment status is not substantial. Conclusions Database and methods are of high quality, however due to the nonexperimental design, omitted variables could lead to bias and limit causal interpretation. The influence of the labour market on RTW is small and proxied to a large extent by individual employment biographies. However, if no (valid) employment biographies are available, the labour market should be included in RTW analyses.

Suggested Citation

  • Christian Hetzel & Sarah Leinberger & Rainer Kaluscha & Angela Kranzmann & Nadine Schmidt & Anke Mitschele, 2023. "Return to work after medical rehabilitation in Germany: influence of individual factors and regional labour market based on administrative data," Journal for Labour Market Research, Springer;Institute for Employment Research/ Institut für Arbeitsmarkt- und Berufsforschung (IAB), vol. 57(1), pages 1-14, December.
    • Handle: RePEc:spr:jlabrs:v:57:y:2023:i:1:d:10.1186_s12651-023-00330-1
    DOI: 10.1186/s12651-023-00330-1
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    References listed on IDEAS

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    1. Alexandra Fedorets & Franziska Lottmann & Michael Stops, 2019. "Job matching in connected regional and occupational labour markets," Regional Studies, Taylor & Francis Journals, vol. 53(8), pages 1085-1098, August.
    2. Taina Leinonen & Svetlana Solovieva & Kirsti Husgafvel-Pursiainen & Mikko Laaksonen & Eira Viikari-Juntura, 2019. "Do individual and work-related factors differentiate work participation trajectories before and after vocational rehabilitation?," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-19, February.
    3. Kolmar, Martin, 2007. "Beveridge versus Bismarck public-pension systems in integrated markets," Regional Science and Urban Economics, Elsevier, vol. 37(6), pages 649-669, November.
    4. Papke, Leslie E & Wooldridge, Jeffrey M, 1996. "Econometric Methods for Fractional Response Variables with an Application to 401(K) Plan Participation Rates," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 11(6), pages 619-632, Nov.-Dec..
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    More about this item

    Keywords

    Return to work; Labour market; Rehabilitation; Orthopaedic; Psychosomatic;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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