M Stallmann | Search PubMed

PubMed1999

[Subjective health, need for rehabilitation and utilization in a West-East comparison--results of a survey of insured clients of the federal insurance office for employees and the Saxony federal insurance office].

There were substantial changes within the rehabilitation framework due to new laws as well as internal need for more flexibility. In connection with this process, the BfA and the LVA Sachsen initiated a survey among their insured persons, the main points being the need for and use of rehabilitative care. The results of a West/East comparison are presented. A questionnaire was send to approximately 29,000 insured persons, the overall response rate was 43%. White collar workers in the East reported a better state of health compared with those in the West, with the most profound differences found in females. Subjective health status and subjective working capability were highly associated. The proportion of persons who reported a need for rehabilitation amounts to 24% among the insured with the LVA Sachsen (blue collar workers, East) and 12% among the white collar workers in the East. Independent of the state of health there was also an association between work stress and the need for rehabilitation. Persons from the East were less informed about rehabilitative care than persons from the West. Financial and workplace problems were among the major reasons not to apply for a rehabilitation measure even if there is a need. These reasons were mentioned more often in the East. In conclusion, there are substantial differences between West and East concerning the rehabilitative health sector. A prominent role is played by the employment situation.

Adult↗

PubMed1996

[Statistical methodologic comments on epidemiologic work disability trends].

The term "epidemiological absenteeism trend"-especially as used in Germany-was defined by Wagner in 1977 and has since entered the sickness-absence discussion as an outcome indicator of medical rehabilitation. In its key concepts, the term refers to the fact that although there is a constant trend in absenteeism over time, individuals show changes in absenteeism from one measurement to the next. Evaluations of those individuals who have very high (or low) absence rates change to a higher degree than do those of individuals with mean scores on the absenteeism index; nevertheless, the summation of all deviations will be zero. In evaluating absence reduction due to rehabilitation, this fact must be considered. Because people who take part in medical rehabilitation show high absenteeism before they start its intervention, there will be--according to Wagner's absenteeism trend--a higher rate of reduction in sickness absence in the time following rehabilitation than there will be for people with medium scores. This paper investigates the hypothesis that the epidemiological absenteeism trend is identical with Galton's discovery--roughly 100 years before Wagner's definition--generally referred to as "reversion". Galton developed this term as the fundamental concept for regression and correlation. It can be shown that the absenteeism trend does not give a special description of sickness-absence but is rather the results of applying regression analysis. With the help of the statistical method of log linear modelling, a re-analysis of Wagner's data is performed in which the term epidemiological absenteeism trend is not necessary. In consequence, it is argued that this term should be abandoned or given a new meaning.

Absenteeism↗