Risk of Reduced Earning Capacity Pension due to Cardiovascular Diseases after Medical Rehabilitation: An Event History Analysis based on German Statutory Pension Insurance Data

• Published in: Gesundheitswesen (Bundesverband der Ärzte des Öffentlichen Gesundheitsdienstes (Germany)) Vol. 82; no. 10; p. 786
• Main Authors: Barth, Alexander, Aretz, Benjamin, Doblhammer, Gabriele
• Format: Journal Article
• Language: German
• Published: Germany 01-10-2020
• Subjects: Cardiac Rehabilitation; Cardiovascular Diseases; Female; Germany - epidemiology; Humans; Income; Life Change Events; Male; National Health Programs; Pensions; Germany
• ISSN: 1439-4421
• DOI: 10.1055/a-0832-2117

Not much is known on risks for reduced earning capacity pensions (RECP) for patients with specific diseases. Our study focusses on individuals who have completed a course of rehabilitation due to cardiovascular disease.
This study is based on a scientific use file from the German statutory pension insurance that covers completed rehabilitations between 2006-2013. Using survival analysis, we modeled the transition into RECP in general and for specific diagnostic groups. We used Kaplan-Meier-estimates and age-standardized and sex-specific transition rates. Multivariate Cox Proportional Hazard models are used to identify the most important socio-demographic risk factors for RECP.
Patients who completed rehabilitation after cerebral infarction, cardiomyopathy or cerebrovascular diseases were most likely to transition into RECP due to these diseases. The most important socio-demographic risk factors for RECP were low educational attainments, part-time or no employment and living in Eastern Germany.
Especially patients with cerebral infarction, cardiomyopathy or cerebrovascular diseases require successful medical rehabilitation. In case of multimorbid patients, these diagnoses require special attention. Also, the reintegration into the labor market of people from lower social strata after medical rehabilitation to avoid RECP appears to be especially difficult.