Work ability score as predictor of rehabilitation, disability pensions and death? A German cohort study among employees with back pain.

BACKGROUND: Sickness absence, disability pensions, and use of healthcare due to disabling back pain are a high economic burden in Germany. Assessment are needed to identify employees who are likely to need intensive support. OBJECTIVE: The cohort study examined whether rehabilitation, disability pensions and death can be predicted by a simple self-reported rating of work ability in employees with back pain in Germany. METHODS: Employees aged 45 to 59 years who reported back pain in the last 3 months completed the Work Ability Score in 2017 (0-10 points). Individual scores were categorized into poor (0-5 points), moderate (6-7) and at least good (8-10) work ability. Outcomes were extracted from administrative records covering the period until the end of 2018. Proportional hazard models were fitted to determine the prognostic benefit of the Work Ability Score. RESULTS: Data for 6,917 participants were included (57.8% women). The median follow-up time was 20 months. Of the participants, 52.1% had a good or excellent, 27.7% a moderate, and 20.2% a poor Work Ability Score. During follow-up, 548 persons were granted rehabilitation measures, 57 persons disability pensions, and 23 died. Fully adjusted analyses showed an increased risk of a rehabilitation measure (hazard ratio = 2.65; 95% CI 2.11; 3.34) and a disability pension (HR = 4.12; 95% CI 2.02; 8.39) in employees with poor work ability. A premature death was not associated with poor work ability. CONCLUSIONS: The Work Ability Score is a potential tool to identify individuals, reporting back pain, with an increased risk of health-related early retirement and work disability.