Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries
Polina Putrik
(1)
,
Sofia Ramiro
(2)
,
Francis Guillemin
(3)
,
Márta Péntek
(4, 5)
,
Francisca Sivera
(6)
,
Tuulikki Sokka
(7)
,
Maarten J. de Wit
(8)
,
Anthony Woolf
(9)
,
Angela Zink
(10)
,
Daina Andersone
(11)
,
Florian Berghea
(12)
,
Irena Butrimiene
(13)
,
Sandra Brouwer
(14)
,
Karen Cassar
(15)
,
Paraskevi Charalambous
(16)
,
Roberto Caporali
(17, 18)
,
Elena Deseatnicova
(19)
,
Nemanja Damjanov
(20)
,
Axel Finckh
(21)
,
Oliver Fitzgerald
(22)
,
Gerður Gröndal
(23)
,
Nino Gobejishjvili
(24)
,
Piotr Gluszko
(25)
,
Marco Hirsch
(26)
,
Igor Jovanovic
(27)
,
Jiří Vencovský
(28)
,
Xavier Janssens
(29)
,
Andras Keszei
(30)
,
Maria Kovarova
(31)
,
Mart Kull
(32)
,
Luís Cunha Miranda
(33)
,
Miroslav Mayer
(34)
,
Snezana Misevska - Percinkova
(35)
,
Nevsun Inanc
(36)
,
Oleg Nadashkevich
(37)
,
Ingemar Petersson
(38)
,
Kari Puolakka
(39)
,
Bernadette Rojkovich
(40)
,
Helga Radner
(41)
,
Fruzsina Szabados
(42)
,
Gleb Slobodin
(43)
,
Ivan Shirinsky
(44)
,
Nikolay Soroka
(45)
,
Prodromos Sidiropoulos
(46)
,
Russka Shumnalieva
(47)
,
Sekib Sokolovic
(48)
,
Surayo Shukurova
(49)
,
Argjend Tafaj
(50)
,
Matija Tomšič
(51)
,
Till Uhlig
(52)
,
Suzanne Verstappen
(53, 54)
,
Annelies Boonen
(1)
1
MUMC -
Maastricht University Medical Centre
2 LUMC - Leiden University Medical Center
3 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
4 Rheumatology
5 Corvinus University of Budapest
6 Hospital de Elda
7 Central Hospital of Jyväskylä
8 VU University Medical Center [Amsterdam]
9 Royal Cornwall Hospital
10 Charité - UniversitätsMedizin = Berlin University Medicine
11 Riga East University Hospital
12 UMPCD - University of Medicine and Pharmacy “Carol Davila”
13 Vilnius University [Vilnius]
14 UMCG - University Medical Center Groningen [Groningen]
15 University of Malta [Malta]
16 Cyprus Society for Rheumatology
17 Policlinico San Matteo
18 UNIMI - Università degli Studi di Milano = University of Milan
19 Université d'Etat de Médecine et Pharmacie, Chisinau, Republic of Moldova
20 School of Medicine [Belgrade]
21 HUG - Geneva University Hospital
22 St Vincents University Hospital
23 Landspitali National University Hospital of Iceland
24 Ilia State University [Tbilisi]
25 National Institute of Geriatrics, Rheumatology and Rehabilitation
26 DFKI - Deutsches Forschungszentrum für Künstliche Intelligenz GmbH = German Research Center for Artificial Intelligence
27 Filipovic polyclinic
28 Institute of Rheumatology
29 Ghent University Hospital
30 RWTH Aachen - RWTH Aachen University = Rheinisch-Westfälische Technische Hochschule Aachen
31 Trnava University
32 Tartu University Hospital
33 Portuguese Institute of Rheumatology
34 University of Zagreb
35 UKIM - Ss. Cyril and Methodius University in Skopje
36 Marmara University [Kadıköy - İstanbul]
37 Danylo Halytsky Lviv National Medical University [Lviv, Ukraine]
38 Skane University Hospital [Lund]
39 South Karelia Central Hospital
40 Semmelweis University [Budapest]
41 Medizinische Universität Wien = Medical University of Vienna
42 North Denmark Regional Hospital
43 Bnai Zion Medical Center
44 Research Institute of Fundamental and Clinical Immunology
45 Society of Internal Medicine of Belarus
46 UOC - University of Crete [Heraklion]
47 Medical University of Sofia [Bulgarie]
48 UNIVERSITY OF SARAJEVO - UNIVERZITET U SARAJEVU
49 Medical Science Academy, Dushanbe
50 University of Tirana
51 Faculty of Chemistry and Chemical Technology
52 NKRR - National Advisory Unit on Rehabilitation in Rheumatology
53 University of Manchester [Manchester]
54 University of Southampton
2 LUMC - Leiden University Medical Center
3 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
4 Rheumatology
5 Corvinus University of Budapest
6 Hospital de Elda
7 Central Hospital of Jyväskylä
8 VU University Medical Center [Amsterdam]
9 Royal Cornwall Hospital
10 Charité - UniversitätsMedizin = Berlin University Medicine
11 Riga East University Hospital
12 UMPCD - University of Medicine and Pharmacy “Carol Davila”
13 Vilnius University [Vilnius]
14 UMCG - University Medical Center Groningen [Groningen]
15 University of Malta [Malta]
16 Cyprus Society for Rheumatology
17 Policlinico San Matteo
18 UNIMI - Università degli Studi di Milano = University of Milan
19 Université d'Etat de Médecine et Pharmacie, Chisinau, Republic of Moldova
20 School of Medicine [Belgrade]
21 HUG - Geneva University Hospital
22 St Vincents University Hospital
23 Landspitali National University Hospital of Iceland
24 Ilia State University [Tbilisi]
25 National Institute of Geriatrics, Rheumatology and Rehabilitation
26 DFKI - Deutsches Forschungszentrum für Künstliche Intelligenz GmbH = German Research Center for Artificial Intelligence
27 Filipovic polyclinic
28 Institute of Rheumatology
29 Ghent University Hospital
30 RWTH Aachen - RWTH Aachen University = Rheinisch-Westfälische Technische Hochschule Aachen
31 Trnava University
32 Tartu University Hospital
33 Portuguese Institute of Rheumatology
34 University of Zagreb
35 UKIM - Ss. Cyril and Methodius University in Skopje
36 Marmara University [Kadıköy - İstanbul]
37 Danylo Halytsky Lviv National Medical University [Lviv, Ukraine]
38 Skane University Hospital [Lund]
39 South Karelia Central Hospital
40 Semmelweis University [Budapest]
41 Medizinische Universität Wien = Medical University of Vienna
42 North Denmark Regional Hospital
43 Bnai Zion Medical Center
44 Research Institute of Fundamental and Clinical Immunology
45 Society of Internal Medicine of Belarus
46 UOC - University of Crete [Heraklion]
47 Medical University of Sofia [Bulgarie]
48 UNIVERSITY OF SARAJEVO - UNIVERZITET U SARAJEVU
49 Medical Science Academy, Dushanbe
50 University of Tirana
51 Faculty of Chemistry and Chemical Technology
52 NKRR - National Advisory Unit on Rehabilitation in Rheumatology
53 University of Manchester [Manchester]
54 University of Southampton
Sofia Ramiro
- Function : Author
- PersonId : 779427
- ORCID : 0000-0002-8899-9087
Francis Guillemin
- Function : Author
- PersonId : 757347
- IdRef : 068536569
Axel Finckh
- Function : Author
- PersonId : 791335
- ORCID : 0000-0002-1210-4347
Oliver Fitzgerald
- Function : Author
- PersonId : 763873
- ORCID : 0000-0002-6607-6070
Suzanne Verstappen
- Function : Author
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.