Workforce connection at first admission with AECOPD and age at permanent detachment

Introduction: Many patients with chronic obstructive pulmonary disease (COPD) experience early retirement. Understanding the magnitude of COPD patients outside the workforce, and when permanent detachment (PD) from the workforce takes place may facilitate interventions aimed at retaining workforce connection. Aims: To examine workforce connection of patients admitted with acute exacerbation of COPD (AECOPD) for the first time and exploring the median age at PD. Method: This nationwide retrospective cohort study, based on Danish registry data, included patients 35-64 years at first admission with AECOPD between 1999-2015, excluding patients with a previous asthma diagnosis. Workforce connection was divided into working, unemployment benefit, sick leave, early retirement, and early voluntary retirement (Danish voluntary detachment benefit available from the age of 60). Early retirement and early voluntary retirement were treated as PD. Two age estimates at PD were calculated, one including patients receiving PD benefits at the time of the work registry’s beginning at 1993 and one excluding these patients. Results: The study included 22,499 patients with 5,457 (24%) working, 1,844 (8%) on unemployment benefit, 1,135 (5%) on sick leave, 11,711 (52%) on early retirement and 2,352 (11%) on early voluntary retirement. PD was seen in 62.5% (14,063/22,499). Median age at PD was 50 years interquartile range (44-57 years) and when excluding patients receiving PD benefits at the beginning of the registry (N = 10,260) the average age was 53 years (46-60). Conclusion: At first admission 63% received PD benefits. The median age at PD in patients with accurate date of PD was 53 years. Early intervention is needed to avoid PD.