POS1475-HPR EXPLORING CHANGES IN BENEFIT STATUS IN THE YEAR BEFORE AND AFTER REHABILITATION: A CASE-CONTROL STUDY.

Background: Most industrialized countries experience a substantial increase in long-term sick leave and work disability benefits, and people leave the labour market permanently due to health problems or work disability. We have limited knowledge on how multidisciplinary rehabilitation impacts benefit status longitudinally across different diagnostic rehabilitation groups. Objectives: To explore the changes in benefit status over three years in a rehabilitation group compared to matched controls. Methods: This longitudinal multicentre cohort study (RehabNytte) involved 17 rehabilitation institutions from the Norwegian specialist health care service and more than 3700 patients, with the primary diagnosis (~38 %) being rheumatic and musculoskeletal diseases (RMDs). Participants received either multidisciplinary rehabilitation or usual care, with each rehabilitant (N = 2 710) propensity score matched to 37 760 non-rehabilitants (control group) from the Norwegian Labour and Welfare Administration, applying sociodemographic factors such as age, gender and region of residence, and benefit status for matching. Benefit status comprises days on sick leave, work assessment allowance and disability benefits, quantified by accumulating compensated whole workdays per person per month for the 3 year-period, with identical assessment points for the control group. Linear regression was used to explore differences between the two groups on days on sick leave, work assessment allowance and disability benefits in the year after rehabilitation, as well as subgroup analysis of the RMD population. Results: After propensity score matching, baseline age was approximately 41 (SD 12) years, and 70 % were females (Table 1). In the year before rehabilitation (months 1-12), mean (SD) benefit days per person per month for rehabilitation vs. control group were 2.3 (5.1) vs. 1.9 (4.8) for sick leave; 0.8 (3.7) vs. 0.7 (3.5) for work assessment allowance; and 0.5 (3.1) vs. 0.6 (2.8) for disability benefits. In the year post rehabilitation (months 25-36) the mean days on benefits per person per month were 0.2 days less (p>0.001) on sick leave in the rehabilitation group vs. the control group, 3.8 more days (p>0.001) on work assessment allowance in the rehabilitation group, and 0.5 more days (p>0.001) on disability benefits in the rehabilitation group (Figure 1). Subgroup analysis of people with RMDs in the year post rehabilitation showed that mean days on benefits per person per month for sick leave were not significantly different in the rehabilitation group vs. controls (p=0.9), but in the rehabilitation group, there were 1.5 more days (p>0.001) on work assessment allowance, and 1.7 less days (p>0.001) on disability benefits. Conclusion: In the year following rehabilitation, sick leave days decreased marginally, while there was an increase in work assessment allowance and disability benefits within the rehabilitation group, compared to controls. Notably, for people with RMDs, the rehabilitation group had significantly fewer days on disability benefits compared to the control group. The results suggest that rehabilitation may play a significant role in identifying those in need of in need of more permanent support while reducing sick leave. The marginal increase in disability benefits in the rehabilitation group, and the reduction in the RMD subgroup, suggest that rehabilitation may help prevent progression to long-term disability. Figure 1Mean days per person per month on benefits for the rehabilitation and control group for the tree year period. Vertical line is rehabilitation start (month 13). Solid line indicates rehabilitation group, dotted line indicates control group. Red line is sick leave, orange is work assessment allowance and blue is disability benefits. REFERENCES: [1] Hemmings, P., Prinz, C. (2020). SICKNESS AND DISABILITY SYSTEMS: COMPARING OUTCOMES AND POLICIES IN NORWAY WITH THOSE IN SWEDEN, THE NETHERLANDS AND SWITZERLAND . OECD,. Retrieved 14.11.23 from https://one.oecd.org/document/ECO/WKP(2020)9/en/pdf. [2] OECD. (2010). Sickness, Disability and Work: Breaking the Barriers . https://doi.org/10.1787/9789264088856-en. Table 1Distribution of sociodemographic factors and work disability benefits among participants receiving rehabilitation and a matched control group.Intervention groupControl groupN (%)N (%)Age (mean, SD)42.8 (11.7)41.1 (12.0)Gender (female)26 968 (72.1)28 266 (69.5)Region of residenceWest6409 (17.3)6440 (15.8)South east26 797 (71.6)29 391 (72.2)North734 (2.0)819 (2.0)Middle3476 (9.3)4035 (9.9)Diagnosis*Rheumatic and musculoskeletal diseases1130 (41.9)2126 (34.3)Cancer584 (21.6)-Mental health-1616 (26.1)Other main diagnosis986 (36.5)2461 (39.7)Mean days (SD) on benefits per month 1 year before rehab (month 1-12)Sick leave2.3 (3.5)1.9 (3.3)Work assessment allowance0.8 (3.2)0.7 (3.1)Disability benefits0.5 (3.1)0.6 (2.8)*Unmatched. SD: Standard Deviation Acknowledgements: NIL . Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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