Predictive factors of future participation in rehabilitation in the working population: the Finnish public sector study.

OBJECTIVE To examine factors that predict the probability of an employee being granted in-patient multidisciplinary rehabilitation to sustain worklife participation. DESIGN A prospective cohort study. SUBJECTS A total of 49,264 public sector employees. METHODS Baseline characteristics were measured from survey responses and registers. Two types of rehabilitation were identified: early (for employees only at risk of their work capacity deteriorating in the near future) and later (for employees whose work capacity has already deteriorated substantially). RESULTS During the mean 5.0-year follow-up, 1551 participants were granted early rehabilitation and 1293 received later rehabilitation. Early rehabilitation was predicted by a permanent job, high occupational status, good job control and job security, non-smoking and high physical activity. Both early and later rehabilitation were predicted by the use of painkillers, anxiety, and sickness absence. Later rehabilitation was also predicted by older age, poor self-rated health, and low educational level. CONCLUSION Early rehabilitation and, to a lesser extent, later rehabilitation were more often granted to employees with few known risk factors. This finding suggests that preventive measures to reduce the risk of disability pension amongst high-risk employees through rehabilitation are not targeted as intended.