The Prevalence and Determinants of Being Offered and Accepting Operational Management Services—A Cohort Study

In Germany, employers are obliged to offer “operational integration management” (OIM) services to employees returning from long-term sick leave. OIM aims to improve employees’ workability and to prevent future sick leave or early retirement. This study examined (i) to what extent OIM services are offered to eligible employees, (ii) to what extent offers are accepted and (iii) the determinants of both outcomes. We used data from a cohort of employees eligible for OIM. Thirty-four potential determinants were assessed in 2013 (i.e., the baseline) using participant reports. In 2015 (i.e., the follow-up), participants were asked (a) whether they had ever been offered OIM services by their employer, and (b) whether they had accepted that offer (i.e., the outcomes). We estimated relative risks by multivariable binomial regression to identify predictors based on backward elimination. In total, 36.0% of the participants were offered OIM services and 77.2% of them accepted that offer. The likelihood of an OIM offer at follow-up was elevated in participants with mental impairment, cancer or long-term absenteeism and increased with organizational justice, neuroticism, and company size. The likelihood of accepting that OIM offer was positively associated with mental impairment and decreased with increasing company size.

Disease-related impairment at work, mean (SD), potential score range =

Additional information on the measurement of health-related variables and psychological variables
Health-related variables included:  Diseases: Reports of accidents and twelve current physician-diagnosed disease groups (see Table 1 in the manuscript), as measured by the Work Ability Index (WAI) [1].
 Work ability, as assessed by two variables from the WAI [1], which were analyzed separately. The first item asked respondents to rate their current work ability compared to the best level of work ability they had ever attained on a scale ranging from 0 (worst) to 10 (best). The second construct was the level of experienced disease-related impairment at work. This construct was assessed by six items that were presented as statements and participants were asked to indicate whether the respective statement applied or not. The resulting total score ranged from 1 to 6 with higher levels indicating less health-related impairment at work.
 Quality of life (QoL) was measured by the German version of the 36-item Short Form Health Survey (SF-36) [2]. We used both the mental health summary score and the physical health summary score. Either score can vary from 0 to 100 and higher scores reflect better health.
 Absenteeism was measured by a WAI item [1] inquiring after the number of days one had been absent from work due to health problems (sickness or health care utilization) throughout the previous 12 months (Response options: none; up to 9 days; 10-24 days; 25-99 days; and 100-365 days).
 Number of visits to the general practitioner as reported during the 12 month prior to data collection.

Psychological factors included:
 Social support was assessed by the 3-item Oslo Social Support Scale [3]. The total score potentially ranges from 3 to 14 whereby higher scores indicated higher social support.
 Effort-Reward-Imbalance (ERI): The ERI model conceptualizes work stress in terms of efforts that exceed one's rewards at work [4,5]. A third component of this model is overcommitment, which is de-fined as an excessive and intrinsically motivated work drive [5]. We used a abbreviate questionnaire [6] and calculated the ER ratio as recommended [6]. Higher scores indicated more work stress in terms of the ERI model. Overcommitment (measured by six items) was used as a separate variable, that is, a sum score potentially varying from 6 to 24 whereby higher scores reflect more overcommitment.
 Organizational justice (OJ): OJ is a work stress concept that emphasizes the role of fairness perceptions at workplaces [7,8]. OJ was assessed by an established 13-item German-language instrument [9]. The level of agreement with each item was to be expressed on a 5-point scale. We calculated a mean score across all items (potential range: 1-5). Higher scores indicate higher perceived OJ.
 Personality: The German-language Big Five Inventory was employed to capture personality traits [10].
The five key personality traits of the Big Five model [11] are measured by three statements each and agreement is reported using a 7-point response format ("1= does not apply at all" to "7=fully applies").
The five measured traits are labeled neuroticism (i.e. proneness to experiencing psychological stress), extraversion (i.e. the tendency to be socialable, outgoing and energetic), agreeableness (i.e. the tendency to be cooperative and not competitive towards others), conscientiousness (i.e., proneness to be selforganized, self-disciplined and to aim for achievement), and openness to experience (i.e., curiosity and a preference for novelty rather than routines).
Company size: Participants reported the number of employees at their current company. Replies were provided by four categories (<10; 10-49; 50-240, and 250+ employees). The first two categories were combined (i.e. < 49 employees) into a single category (labeled "small") due to low numbers.