Success rate and predictors of return to work after implementation of a formal return-to-work trajectory: A retrospective cohort study

Abstract

Background: Long term sick leave (SL) is increasing in Europe, several countries have legislative initiatives to reduce long-term absenteeism.

Objective: We evaluated the impact of a legally defined return-to-work (RTW) trajectory on the RTW of employees on sick leave in Belgium.

Methods: This was a retrospective register-based cohort study of employees (n = 1416) who followed an RTW trajectory in 2017. We linked workers' data from a prevention service with social security data. By multinomial logistic regression, we analysed which characteristics predicted the RTW with the same or another employer.

Results: One year after their RTW trajectory, 69.2% of the 1416 employees did not RTW; 10.7% returned to work with the same employer and 20.1% with a new employer. Duration of SL was an important predictor for the RTW with both the same employer and another employer. The odds of RTW were lower when the SL duration was > 6 months compared to < 6 months. Marital status, organization-size, and the occupational physician decision had a significant impact on the RTW with the same employer. Age and who initiated the RTW-trajectory were important predictors on the RTW with another employer.

Conclusions: Overall, 30.8% of employees returned to work after their RTW trajectory. A one-size-fits-all approach is not recommended. A stepped approach with an early, informal start of the RTW process is advised. When employees or employers fail to initiate the RTW on their own, a legally defined RTW trajectory could be useful. In particular, RTW with another employer seemed a positive effect of the RTW-trajectory.

Keywords: Sick leave; occupational health; retrospective study; return to work.

Fig. 1

The proportion of no return to work (RTW), RTW with the same employer, and RTW with another employer according to the sick leave duration.