Return-to-work and Job Retention in Workers with Occupational Injuries and Diseases

Abstract

INTRODUCTION Since 2007 in Korea, the annual number of workers with occupational injuries and diseases was more than 90,000, and the injuries and diseases result in considerable negative impacts. Return-to-work (RTW) is an effective way to prevent and reduce negative effects. Although there are researches and policies promoting RTW of workers, post re-entry situation of returned workers were not well understood. For successful RTW, it is necessary to understand the current situation of job retention along with re-entry after occupational injuries and diseases. Furthermore, researches on impacts of RTW type and period on job retention are also required. Therefore, the objective of this study is to understand the current situation and explore the related factors of RTW including both re-entry and retention, also, this study aims to investigate the impacts of RTW type and period on job retention.

METHODS The Panel Study of Workers’ Compensation Insurance including data from 2,000 systemically sampled workers who had finished recuperation in 2012 was used in this study. Impacts of sociodemographic, work-related, and accident related factors were examined according to the workers’ RTW status and retention status. In the first analysis, the relationship between RTW (returned to original work or reemployed) and the factors were examined by logistic regression analyses. In the second analysis, the relationship between 24-month retention according to RTW type and other factors was examined by logistic regression analyses. In the third analysis, the relationship between job retention, regardless of period, according to RTW type and other factors was examined by Cox’s proportionalhazards model. In the fourth analysis, the relationship between job retention according to RTW period was examined.

RESULTS The RTW rate in this study was 80.5% (original work: 35.9% and reemployed: 44.7%). In total workers, age, perceived health status, recuperation period, and disability rating were related to RTW. In workers returned to original work, age, education level, industry, perceived health status, accident type, recuperation period, rehabilitation service utilization, and maintenance of a relationship with employer were related to RTW. In reemployed workers, industry, perceived health status, recuperation period, disability rating, and maintenance of a relationship with employer were related to RTW. RTW type was related to 24-month job retention with OR for non-retention of 3.88 (2.86-5.28) in reemployed workers. In total workers, age, education level, perceived health status, accident type, and RTW consultation were related to 24-month retention. In workers returned to original work, age, education level, perceived health status, and recuperation period was related to 24-month retention. In reemployed workers, education level and perceived health status were related to 24-month retention. In the survival analyses, RTW type was related to job retention with HR for non-retention of 2.66 (2.11-3.35). RTW period was related to job retention with HR for non-retention of 3.03 (1.52-6.04) in the workers returned in 13 – 24 months and 5.33 (2.14-13.25) in the workers returned after 24 months.

DISCUSSION In this study, there are notable results which can be considered in policy implementation. First, higher non-retention rate in the second year in returned to original work group was shown. Therefore period for fund supporting, which is now up to 1 year, needs to be considered for extension. Second, lower job retention probability in reemployed group was shown. Therefore, protection policies for the reemployed workers or benefits to the employers are needed. Third, RTW period was shown as a good prognostic factor for job retention. Therefore, shortening recuperation period along with delay in RTW should be considered.

CONCLUSION Job retention is an important process in RTW. Considering that reemployed workers and workers with RTW period of more than 13 months are at more risks for non-retention, policies encouraging return to original workplace, protecting reemployed workers, and promoting early RTW should be considered.