Alternative measures reveal different but low estimates of labour market attachment after severe traumatic brain injury: A nationwide cohort study

OBJECTIVE: To explore if the definition of labour market attachment (LMA) changes LMA proportions after severe traumatic brain injury (TBI).

DESIGN: Cohort study with 5-year follow-up.

PARTICIPANTS: Patients aged 18-64 years with severe TBI from 2004 to 2012 (n = 637) and matched controls (n = 2497).

METHODS: LMA was defined in three ways. All definitions included patients working with no government benefits. Definition 2 included patients receiving unemployment benefits (LMA-unemployment benefits). Definition 3 included patients receiving supplemental benefits/services such as patients involved in work-activation schemes (LMA supplementary benefits). First week of return to work (RTW), stable LMA first year after RTW and weekly LMA prevalence were calculated. Patients and controls were compared using multivariable conditional logistic regression.

RESULTS: LMA unemployment benefits had similar proportions to LMA with no benefits. These estimates were lower than LMA supplemental benefits where 52% attempted to RTW and 31% achieved stable LMA within 2 years. The maximal LMA prevalence (LMA supplementary benefits) decreased from 33 to 30% from years 2 to 5. Adjusted odds ratios were 0.05 and 0.06 for years 1 and 2, and 0.07 for stable LMA in patients compared to controls.

CONCLUSION: LMA proportions differed depending on the definition. Regardless of definition, LMA proportions following severe TBI were low in Denmark.