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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 
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.
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Submitted on : Wednesday, January 29, 2020 - 10:09:31 AM
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Polina Putrik, Sofia Ramiro, Francis Guillemin, Márta Péntek, Francisca Sivera, et al.. Patients with rheumatoid arthritis facing sick leave or work disability meet varying regulations: a study among rheumatologists and patients from 44 European countries. Annals of the Rheumatic Diseases, 2019, 78 (11), pp.1472-1479. ⟨10.1136/annrheumdis-2019-215294⟩. ⟨hal-02459020⟩



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