Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries

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Abstract

Objectives
To describe and explore differences in formal regulations around sick leave and work disability (WD) for patients with rheumatoid arthritis (RA), as well as perceptions by rheumatologists and patients on the system’s performance, across European countries.

Methods
We conducted three cross-sectional surveys in 50 European countries: one on work (re-)integration and social security (SS) system arrangements in case of sick leave and long-term WD due to RA (one rheumatologist per country), and two among approximately 15 rheumatologists and 15 patients per country on perceptions regarding SS arrangements on work participation. Differences in regulations and perceptions were compared across categories defined by Gross Domestic Product (GDP), type of social welfare regime, European Union (EU) membership and country RA WD rates.

Results
Forty-four (88%) countries provided data on regulations, 33(75%) on perceptions of rheumatologists (n=539), and 34(77%) on perceptions of patients (n=719). While large variation was observed across all regulations across countries, no relationship was found between most of regulations or income compensation and GDP, type of SS system, or rates of WD. Regarding perceptions, rheumatologists in high GDP and EU-member countries felt less confident in their role in the decision process towards WD (β=-0.5 [95%CI[-0.9;-0.2] and β=-0.5[-1.0;-0.1], respectively). The Scandinavian and Bismarkian system scored best on patients’ and rheumatologists’ perceptions of regulations and system performance.

Conclusions
There is large heterogeneity in rules and regulations of SS systems across Europe in relation to WD of patients with RA, and it cannot be explained by existing welfare regimes, EU membership or country’s wealth.
Original languageEnglish
JournalAnnals of the rheumatic diseases
Early online date19 Aug 2019
DOIs
Publication statusPublished - 2019

Keywords

  • epidemiology
  • outcomes research
  • Rheumatoid arthritis

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