Factors influencing the return to work of patients after hip replacement and rehabilitation

Objective: To determine the incidence of medical and sociocultural factors on the return to work of patients after hip replacement and rehabilitation treatment. Design: Case review. Frequency and association of variables' analysis. Setting: The rehabilitation unit of a general hospital in Oviedo (Spain). This setting is a part of an institutional referral center and is the only state-owned hospital that provides rehabilitation treatment for hospitalized patients from a rural and urban area of about 1,000,000 inhabitants. Patients: 747 patients of both sexes, all of them working before receiving treatment, age range 18 to 64 years. Main Outcome Measures: Relationship of several variables: age, sex, habitat, level of education, type of work, underlying illness, walking ability, pain, and type of social security versus return to work. Results: At discharge, 25% of patients return to work. There is a significant association (p < .001) between return to work and any of the following variables: underlying illness, kind of work, walking ability, habitat, and educational level. Conclusion: The physiopathology of symptoms and signs of the patients is not the unique indicator of whether a person will continue working after hip replacement and rehabilitation treatment. Extramedical factors, such as social status, kind of work, and cultural background, are very influential. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation