Needs Assessment
ORIGINAL RESEARCH ARTICLE
Self-Reported Poor Work AbilityVAn
Indicator of Need for Rehabilitation?
A Cross-Sectional Study of a Sample
of German Employees
ABSTRACT
Bethge M, Spanier K, Neugebauer T, Mohnberg I, Radoschewski FM: Self-
reported poor work abilityVan indicator of need for rehabilitation? A cross-
sectional study of a sample of German employees. Am J Phys Med Rehabil
2015;94:958Y966.
Objective: The purpose of this study was to assess associations of self-
reported work ability as measured by the Work Ability Index (WAI) with modifiable
behavioral and occupational health risks, health service utilization, and intended
rehabilitation and pension requests.
Design: This is a cross-sectional study of a random sample of German
employees aged 40Y54 yrs on sickness benefits in 2012 (trial registration:
DRKS00004824).
Results: In total, 1312 male and 1502 female employees were included in
the analyses. Low WAI scores (i.e., G37 points) were associated with a higher
prevalence of occupational and behavioral health risks; a higher likelihood of fre-
quent visits to general, somatic, and psychologic specialists as well as hospital
stays; and four to six times higher risks of intended rehabilitation and pension
requests. A two-item version of the WAI was as strongly associated with intended
rehabilitation and pension requests as the total score.
Conclusions: This study indicates that the WAI is a sensitive screening tool to
identify workers on sick leave with a probable need for rehabilitation. The WAI could
support the assessment of need for rehabilitation by occupational health services in
return-to-work strategies, which include the opportunity to access multiprofessional
rehabilitation.
Key Words: Needs Assessment, Occupational Health, Rehabilitation, Pensions
Authors:
Matthias Bethge, PhD
Katja Spanier, MA
Tjark Neugebauer, BA
Inka Mohnberg, Dipl-Pa ¨d (Rehab)
Friedrich Michael Radoschewski, MD
Affiliations:
From the Institute of Social Medicine
and Epidemiology, University of
Lu ¨ beck, Lu ¨ beck, Germany (MB, KS);
Centre for Quality Management in
Healthcare, Physicians_ Chamber of
Lower Saxony, Hannover, Germany
(TN); and Institute of Medical
Sociology and Rehabilitation Science,
Charite ´ VUniversita ¨tsmedizin Berlin,
Berlin, Germany (IM, FMR).
Correspondence:
All correspondence and requests for
reprints should be addressed to:
Matthias Bethge, PhD, Ratzeburger
Allee 160, 23562 Lu ¨ beck, Germany.
Disclosures:
MB and FMR planned and designed the
study. MB, KS, and TN analyzed the
data. KS, TN, and IM organized data
management. All authors interpreted
the data, drafted the manuscript, and
read and approved the final manuscript.
The authors declare that they have no
competing interests.
This research was funded by the
Federal German Pension Insurance.
Financial disclosure statements have
been obtained, and no conflicts of
interest have been reported by the
authors or by any individuals in control
of the content of this article.
Editor’s Note:
Supplemental digital content is
available for this article. Direct URL
citations appear in the printed text and
are provided in the HTML and PDF
versions of this article on the journal_s
Web site (www.ajpmr.com).
0894-9115/15/9411-0958
American Journal of Physical
Medicine & Rehabilitation
Copyright * 2015 Wolters Kluwer
Health, Inc. All rights reserved.
DOI: 10.1097/PHM.0000000000000281
958 Am. J. Phys. Med. Rehabil.
&
Vol. 94, No. 11, November 2015
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.