Diagnostic group differences in return to work and subsequent detachment from employment following cardiovascular disease: a nationwide cohort study

Abstract

Aims Return to work and employment maintenance following cardiovascular disease (CVD) are important rehabilitation goals for people of working-age. To identify people in particular need of vocational rehabilitation, we examined differences in return to work and subsequent detachment from employment among people with atrial fibrillation, heart failure, heart valve disease, and ischaemic heart disease. Methods We conducted a nationwide cohort study and included all individuals of working age (35-65 years) who were employed when diagnosed with incident CVD in 2018. We estimated sex- and age-standardized probabilities of remaining employed at three, six, and 12 months after diagnosis, and of detachment from employment within six months after having returned to work. Results Of 46,912 individuals diagnosed in 2018, 8,187 were of working-age and employed at diagnosis. The mean age was 54.7 years (SD = 6.7), and 74.0% were men. Within one year, 89.8% had returned to work, but within the subsequent six months, 23.5% of these experienced detachment from employment. At three, six, and 12 months after diagnosis the highest standardized probability of being employed was found among people with atrial fibrillation, whereas the lowest probability was found among people with heart failure (78.9% (95% CI: 77.3-80.4) vs. 62.2% (95% CI: 59.0-65.4) at 12 months). Similarly, the highest probability of detachment was found for people with heart failure (30.3% (95% CI: 26.9-33.7)). Conclusion People with heart failure present the highest probability of not returning to work. There is a need for developing and documenting effects of vocational rehabilitation strategies within comprehensive cardiac rehabilitation programmes.