Predictors of a high work participation in the flexi-job scheme: a regional Danish cohort study

In Denmark, people with permanent and significant reduced work capacity can be assigned to a flexi-job (FJ) scheme. In 2013, the social security policy for FJ was reformed in order to improve the chances for employment for people with reduced work capacity. In a Danish cohort study from the North Denmark Region we aimed to describe work participation in the flexi-job scheme before and after the reform. Furthermore, we described the associations between employment in the flexi-job scheme and predictors such as sociodemographic factors, healthcare use, and work participation before assignment.The study population included individuals assigned to the FJ scheme between 2010 and 2015 in the North Denmark Region. The study population was followed until leaving the FJ scheme or end of follow up (September 2017). Baseline information included data on sex, age, place of residence, number of contacts to specialized healthcare, and number of working weeks five years before. Work participation score (WPS) was defined as number of working weeks divided with the total number of weeks in the FJ scheme. High WPS was defined as above the median. We used a logistic regression model to study associations between baseline characteristics and high WPS.A total of 4,668 people were included in the study. The overall median WPS were 73\% (interquartile range (IQR) 42\% - 90\. Policy changes (OR 1.40, 95\% confidence interval (CI ): 1.24 - 1.59), male sex (OR 1.16, CI:1.03 - 1.31), young age (OR 1.45, CI: 1.17 - 1.80), urban living (OR 1.22, CI:1.03 - 1.46), no contact to specialized healthcare (OR 1.54, CI: 1.21 - 1.99), and a strong association to the labor market before awarded FJ (OR 4.25, CI: 3.34 - 5.41) were all predictors of a high WPS during FJ-scheme.Policy changes increased work participation in the FJ-scheme. However, the strongest predictor of a high WPS for people awarded FJ was the degree of work participation before the scheme.Several factors had impact on work participation in a flexi-job scheme. The flexi-job scheme might be insufficient to secure employment for people with prior weak affiliation to the labor market.