Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries
Year: 2019
Type: article
Study design: Observational Study
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 to -0.2) and β=-0.5 (95% CI -1.0 to -0.1), respectively). The Scandinavian and Bismarckian 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.
Source: Annals of the Rheumatic Diseases
Authors: Polina Putrik, Sofia Ramiro, Francis Guillemin, Márta Péntek, Francisca Sivera, Tuulikki Sokka, Maarten de Wit, Anthony D Woolf, Angela Zink, Daina Andersone, Florian Berghea, Irena Butrimiene, Sandra Brouwer, Karen Cassar, Paraskevi Charalambous, Roberto Caporali, Elena Deseatnicova, Nemanja S Damjanov, Axel Finckh, Oliver FitzGerald, Gerður Gröndal, Nino Gobejishjvili, Piotr Gluszko, Marco Hirsch, Igor Jovanovic, Jiří Vencovský, Xavier Janssens, Andras P Keszei, Maria Kovarova, Mart Kull, Luís Cunha Miranda, Miroslav Mayer, Snezana Misevska - Percinkova, Nevsun Inanc, Oleg Nadashkevich, Ingemar F Petersson, Kari Puolakka, Bernadette Rojkovich, Helga Radner, Fruzsina Szabados, Gleb Slobodin, Ivan Shirinsky, Nikolay Soroka, Prodromos Sidiropoulos, Russka Shumnalieva, Sekib Sokolovic, Surayo Shukurova, Argjend Tafaj, Matija Tomšič, Till Uhlig, Suzanne M M Verstappen, Annelies Boonen
Institutions: Maastricht University Medical Centre, Maastricht University, Care and Public Health Research Institute, Leiden University Medical Center, Zuyderland Medisch Centrum, Interdisciplinarité en Santé Publique Interventions et Instruments de mesure complexes – Région Est, Université de Lorraine, Corvinus University of Budapest, Kistarcsai Flór Ferenc Kórház, Hospital General de Elda, Central Finland Health Care District, Amsterdam University Medical Centers, Royal Cornwall Hospital, German Rheumatism Research Centre, Charité – Universitätsmedizin Berlin, Pauls Stradiņš Clinical University Hospital, Carol Davila University of Medicine and Pharmacy, Vilnius University, University Medical Center Groningen, University of Groningen, University of Malta, University of Milan, Policlinico San Matteo Fondazione, Nicolae Testemițanu State University of Medicine and Pharmacy, University of Belgrade, University Hospital of Geneva, St. Vincent's University Hospital, National University Hospital of Iceland, National Institute of Geriatrics, Rheumatology and Rehabilitation, Charles University, Institute of Rheumatology, Ghent University Hospital, RWTH Aachen University, University of Tartu, Instituto Português de Reumatologia, University Hospital Centre Zagreb, University of Zagreb, Ss. Cyril and Methodius University in Skopje, Marmara University, Danylo Halytsky Lviv National Medical University, Lund University, Skåne University Hospital, South Karelia Central Hospital, Semmelweis University, Medical University of Vienna, North Denmark Region, Bnai Zion Medical Center, Research Institute of Fundamental and Clinical Immunology, University of Crete, Medical University of Sofia, Clinical Center University of Sarajevo, University of Medicine Tirana, Mother Teresa Hospital, Ljubljana University Medical Centre, Diakonhjemmet Hospital, Manchester Academic Health Science Centre, University of Manchester, NIHR Manchester Biomedical Research Centre, University of Southampton, Centre for Epidemiology Versus Arthritis
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
Awards: G2272001644, G6054570368, G8350335884
OpenAlex ID: W2965479220