Returning to work after heart transplantation.

The purpose of this study was to determine what factors influence a patient's return to work after heart transplantation. Two hundred fifty patients who had undergone heart transplantation were surveyed at seven regional centers in the United States (five of which were Medicare-certified). Of these patients, 45% were employed, 36% were unemployed, 13% were medically disabled, and 6% had retired. A stepwise discriminant analysis resulted in the selection of six variables that helped differentiate those patients who did and those who did not return to work after the transplantation. The factors associated with a patient's return to work included (1) self report of being physically able to work, (2) no loss of health insurance, (3) longer length of time after transplantation, (4) education level of more than 12 years, (5) no loss of disability income, and (6) shorter length of disability before heart transplantation. This information could accurately profile 91% of the patients who were employed, 69% of the patients who were unemployed, and 80% for the entire group. The implication of this study is that social rehabilitation is not synonymous with the medical results of heart transplantation. More attention to social rehabilitation is required if heart transplant recipients are to enjoy a better quality of life and become fully productive members of the community.

Social rehabilitation and return to work after cardiac transplantation--a multicenter survey.

As the medical results of heart transplantation steadily improve, the social rehabilitation of patients, in particular, their ability to return to some form of employment, is becoming increasingly important. Two-hundred fifty patients were therefore surveyed at 7 heart transplant centers (5 of which were Medicare certified) from different geographic regions in the U.S.A. Over all, 45% were employed, 36% were unemployed, 13% were medically disabled, and 6% were retired. Of those employed, 87% had returned to their previous employment, and only 13% had secured new employment. Of the unemployed, 16% had made job applications, and no fewer than 63% had no current plan to seek employment. Factors found to negatively influence a return to work included the following: (1) length of medical disability prior to transplantation; (2) a patient's self-perception of being physically unable to work; and (3) the potential loss of health insurance and/or disability income. At 2 centers, where there was a definite policy of not supporting a patient's claim for medical disability in the absence of an absolute indication, there were significantly increased numbers who (1) secured new employment and (2) planned to seek employment. More serious attention must be paid to aspects of employment if heart transplant recipients are to become fully productive members of the community.