Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for future research

Am J Ind Med. 2001 Oct;40(4):464-84. doi: 10.1002/ajim.1116.


Background: The purpose of this review was to identify critical data and research needs in addressing the following question: What are the primary factors that affect the time lost from work, return-to-work (RTW), subsequent unemployment, and changes in occupation after disabling illness or injury?

Methods: Review of the literature to identify research challenges originating from the multitude of disciplines, data sources, outcome measures, and methodological and analytical problems.

Results: About 100 different determinants of RTW outcomes were identified. Their impact varies across different phases of the disablement process. Recommendations are provided for addressing five selected research challenges.

Conclusion: Interdisciplinary research needs to develop a comprehensive conceptual framework. Priority should be given to studies on specific domains of risk factors meeting five selection criteria: amenability to change; relevance to users of research; generalizability across health conditions, disability phases, and settings; "degree of promise" as derived from qualitative exploratory studies; and capacity to improve measurement instruments. Combining qualitative and quantitative research methods is necessary to bridge existing knowledge gaps.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Accidents, Occupational / economics*
  • Evaluation Studies as Topic
  • Forecasting
  • Humans
  • Insurance, Disability / economics*
  • Job Description
  • Occupational Diseases / complications
  • Occupational Diseases / economics*
  • Occupational Diseases / rehabilitation
  • Regression Analysis
  • Research / trends
  • Research Design / standards
  • Risk Factors
  • Sick Leave / economics*
  • Time Factors