Associations between work ability and work participation after rehabilitation: a longitudinal multicentre cohort study

Objectives: To examine whether work ability at 3 and 12 months after rehabilitation admission was associated with work participation, operationalised as health-related benefit use in the year following rehabilitation. Methods: This prospective longitudinal, multicentre cohort included 2710 Norwegian working-age adults undergoing rehabilitation. The majority had rheumatic and musculoskeletal diseases (42%). Work ability was self-reported using the Work Ability Score at 3 and 12 months after admission. The number of days on health-related benefit sick leave, work assessment allowance, and disability benefits in the year before rehabilitation (year -1); the rehabilitation year (year 0); and the following year (year 1) were extracted from national registries. Associations between work ability and benefit use were examined in linear regression models adjusted for baseline work ability, health and sociodemographic factors, and prior health-related benefit use. Results: Higher work ability at 3 and 12 months was associated with fewer days on work assessment allowance in year 1, with -9.5 (95% CI: -11.9, -7.2) and -10.4 days (95% CI: -12.2, -8.7), respectively. Similarly, higher work ability was also associated with fewer days on disability benefits, with -5.0 days (95% CI: -6.7, -3.3) and -6.3 days (95% CI: -7.9, -4.5), respectively. Higher work ability at 3 months, but not at 12 months, was associated with 1.5 additional sick leave days (95% CI: 0.8, 2.3) in year 1. Conclusions: Postrehabilitation work ability was associated with subsequent work participation, reflected in lower use of health-related benefits. Assessing work ability after rehabilitation may indicate future work participation.