2 YEARS LEGISLATION ON RETURN TO WORK IN BELGIUM: EXPERIENCES OF A - - PowerPoint PPT Presentation

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2 YEARS LEGISLATION ON RETURN TO WORK IN BELGIUM: EXPERIENCES OF A LARGE OCCUPATIONAL HEALTH SERVICE

Godewina Mylle European Conference for Socio Professional Rehabilitation Brussels, March 7th, 2019

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BACKGROUND

• 28/11/2016: new legislation on return to work (RTW)
• Regulation of access to occupational health physicians during sickness

absence to support RTW

• On initiative of employee himself (at any moment during absence)
• Referral by employer (after 4 months of absence)
• Referral by general practitioner (at any moment during absence)
• Referral by medical advisor (at any moment during absence – use of

Quickscan after 2 months of absence (see poster session: Quickscan to assess Risk of Long-Term Sickness absence: predictive validity by Goorts K.))

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OBJECTIVES AND METHODS OF THE STUDY

• What? Assessment of the conditions for which RTW carried out by the

regulations of the new legislation was more successful

• How? By analyzing the trajectories carried out by IDEWE
• one of the largest Occupational Health Services in Belgium
• +/- 800 000 employees under occupational health surveillance
• 5 935 trajectories from 1/1/2017 until 17/12/2018
• Descriptive analyses: distribution of trajectories by gender, age, company

size, initiator, sector of employment and duration of sickness absence

• Regression: to study the relation between the outcome ‘re-integration’ and

the various covariates (see above)

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RESULTS

DISTRIBUTION OF THE TRAJECTORIES BY GENDER (VS. DISTRIBUTION OF EMPLOYEES UNDER SURVEILLANCE)

10 20 30 40 50 60 70 80 90 100 TOTAL GROUP (n=5935) MEN (n=2000) 33,7 WOMEN (n=3935) 66,3 %

10 20 30 40 50 60 70 80 90 100 TOTAL GROUP (n=778804) MEN (n=341896) 43,9 WOMEN (n=436908) 56,1 %

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RESULTS

DISTRIBUTION OF THE TRAJECTORIES BY AGE (VS. DISTRIBUTION OF EMPLOYEES UNDER SURVEILLANCE)

10 20 30 40 50 60 70 80 90 100 TOTAL GROUP (n=5935) Age 15-24 (n=162) 2,7 Age 25-34 (n=1105) 18,6 Age 35-44 (n=1612) 27,1 Age 45-54 (n=1899) 32,0 Age 55 and older (n=1163) 19,6 %

10 20 30 40 50 60 70 80 90 100 TOTAL GROUP (n=773724) Age 15-24 (n=76392) 9,9 Age 25-34 (n=179009) 23,1 Age 35-44 (n=184972) 23,9 Age 45-54 (n=189745) 24,5 Age 55 and older (n=143606) 18,6 %

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RESULTS

DISTRIBUTION OF THE TRAJECTORIES BY COMPANY SIZE (VS. DISTRIBUTION OF EMPLOYEES UNDER SURVEILLANCE)

10 20 30 40 50 60 70 80 90 100 TOTAL GROUP (n=5759) A (n=1949) 33,8 B (n=1355) 23,5 C+ (n=243) 4,2 C- (n=1141) 19,8 D (n=1071) 18,6 %

10 20 30 40 50 60 70 80 90 100 TOTAL GROUP (n=706936) A (n=302415) 42,8 B (n=182078) 25,8 C+ (n=30960) 4,4 C- (n=103769) 14,7 D (n=87714) 12,4 %

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RESULTS

DISTRIBUTION OF THE TRAJECTORIES BY SECTOR OF EMPLOYMENT (VS. DISTRIBUTION OF EMPLOYEES UNDER SURVEILLANCE)

10 20 30 40 50 60 70 80 90 100

Health Sector (n=1607) Industry (n=738) Trade (n=968) Governm ent (n=385) Services (n=943) Construct ion (n=268) Educatio n (n=155) Transport (n=325) Catering industry (n=165) Other Sectors (n=388) TOTAL GROUP (n=5942) 27,0 12,4 16,3 6,5 15,9 4,5 2,6 5,5 2,8 6,5

%

10 20 30 40 50 60 70 80 90 100 Healt h Secto r (n=15 9154) Indust ry (n=74 361) Trade (n=94 292) Gover nment (n=83 398) Servic es (n=63 571) Const ructio n (n=21 989) Educ ation (n=17 1523) Trans port (n=26 638) Cateri ng indust ry (n=12 558) Other Secto rs (n=73 377) TOTAL GROUP (n=780861) 20,4 9,5 12,1 10,7 8,1 2,8 22,0 3,4 1,6 9,4 %

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RESULTS

DISTRIBUTION OF THE TRAJECTORIES BY INITIATOR

10 20 30 40 50 60 70 80 90 100 TOTAL GROUP (n=5935) Employee (n=2210) 37,2 General Practitioner (n=341) 5,7 Medical advisor (n=898) 15,1 Employer (n=2486) 41,9 %

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DISTRIBUTION OF THE TRAJECTORIES BY DURATION OF SICKNESS ABSENCE BEFORE START OF TRAJECTORY

RESULTS

10 20 30 40 50 60 70 80 90 100 TOTAL GROUP (n=3528) <= 1 month (n=184) 5,2 2 to 3 months (n=260) 7,4 4 to 6 months (n=602) 17,1 7 to 12 months (n=919) 26,0 > 1 year (n=1563) 44,3 %

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RESULTS

DISTRIBUTION OF THE RE-INTEGRATION OUTCOME

10 20 30 40 50 60 70 80 90 100 Return possible in

• wn job -

temporary with adaptations (n=500) Return possible in

• wn job in the

future, not at the moment (n=273) Definitive no return possible in own job but return possible in other job (with adaptations) (n=1086) Definitive no return possible in own job, no possible re- integration at the same employer (n=2551) Re-integration too early (n=380) TOTAL GROUP (n=4790) 10,4 5,7 22,7 53,3 7,9 %

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RESULTS

RESULTS OF THE REGRESSION ANALYSIS: PROBABILITY ON NO POSSIBLE RE-EMPLOYMENT MODELED AS OUTCOME

VARIABLES B ESTIMATE STANDARD ERROR OR P VALUE Female employee 0,219 0,074 1,245 0,003 Older employee 0,007 0,003 1,007 0,015 Small Enterprises (<20 employees) 0,433 0,070 1,541 0,000 Initiator employee 0,000 Initiator medical advisor

• 1,540

0,100 0,214 0,000 Initiator general practitioner

• 0,065

0,135 0,937 0,633 Initiator employer

• 0,653

0,071 0,520 0,000

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RESULTS

RESULTS OF THE REGRESSION ANALYSIS: PROBABILITY ON NO POSSIBLE RE-EMPLOYMENT MODELED AS OUTCOME

VARIABLES B ESTIMATE STANDARD ERROR OR P VALUE Other Sectors 0,001 Health Sector

• 0,087

0,136 0,916 0,512 Industry

• 0,071

0,151 0,932 0,640 Trade 0,292 0,144 1,339 0,043 Government

• 0,363

0,177 0,695 0,040 Services 0,041 0,148 1,042 0,783 Construction 0,273 0,194 1,314 0,159 Education

• 0,010

0,226 0,990 0,966 Transport

• 0,015

0,186 0,985 0,936 Catering industry 0,252 0,220 1,287 0,252

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CONCLUSION

• Re-integration was suggested by the Occupational Health Physician of

IDEWE for 33,1% of the initiated trajectories

• RTW is most challenging for older women, working in small enterprises,

in the trade sector, when initiated by the employee him/herself

• Earlier guidance to re-employment into a more suitable job is

indispensable to avoid long-term absence

• Cooperation with medical advisors and general practitioners towards

RTW is highly recommended

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Head office

Interleuvenlaan 58 3001 Heverlee Tel.: +32 16 39 04 11

Email | Website

info@idewe.be | www.idewe.be info@ibeve.be | www.ibeve.be

Godewina Mylle

Occupational Health Physician

godewina.mylle@idewe.be