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Background <p>To strengthen prevention and rehabilitation in the workforce, the German Pension Insurance (GPI) is mandated to offer a work-related health examination for individuals aged 45 and over (check-up 45+) within a pilot project framework. We are evaluating the effects of the check-up 45+ on the utilization of preventive and rehabilitative services in the pilot project of GPI Bavaria South.</p> Methods <p>The GPI agency selected individuals based on inclusion criteria and randomized them into either the intervention group (IG) or the control group (CG). Data on personal characteristics and service utilization are available in the administrative data of the GPI and are supplemented by additional case documentation for the IG. We conducted descriptive and inferential statistical analyses using intention-to-treat (ITT) and per-protocol (PP) approaches.</p> Results <p>The study includes 20,229 individuals (IG: 10,106; CG: 10,123), with 4.5% of the IG participating in the check-up 45+. In the ITT, the application rate for preventive services is six times higher in the IG than in the CG (p &lt; .001), while for rehabilitative services, it is 1.2 times higher (p ≤ .01). In the PP, effects are more pronounced for both preventive (RR = 110.8, p &lt; .001) and rehabilitative (RR = 2.9, p &lt; .001) services.</p> <p>Participation in the check-up 45+ significantly influences the timing of preventive service applications while this effect is less pronounced for rehabilitative services.</p> Conclusion <p>This pilot strategy effectively identifies previously unrecognized needs for prevention or rehabilitation and increases service utilization. However, it primarily targets individuals with a low risk of premature workforce exit.</p>

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Effects of a Work-Related Health Check (Check-Up 45+) on Utilization of Preventive and Rehabilitative Services - Results from a Randomized Controlled Trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月11日

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  • Simone Telenga,
  • Annika Hambrecht,
  • Renate Wiedemann,
  • Sarah Haberstroh,
  • Eva Maria Bitzer

摘要

Background

To strengthen prevention and rehabilitation in the workforce, the German Pension Insurance (GPI) is mandated to offer a work-related health examination for individuals aged 45 and over (check-up 45+) within a pilot project framework. We are evaluating the effects of the check-up 45+ on the utilization of preventive and rehabilitative services in the pilot project of GPI Bavaria South.

Methods

The GPI agency selected individuals based on inclusion criteria and randomized them into either the intervention group (IG) or the control group (CG). Data on personal characteristics and service utilization are available in the administrative data of the GPI and are supplemented by additional case documentation for the IG. We conducted descriptive and inferential statistical analyses using intention-to-treat (ITT) and per-protocol (PP) approaches.

Results

The study includes 20,229 individuals (IG: 10,106; CG: 10,123), with 4.5% of the IG participating in the check-up 45+. In the ITT, the application rate for preventive services is six times higher in the IG than in the CG (p < .001), while for rehabilitative services, it is 1.2 times higher (p ≤ .01). In the PP, effects are more pronounced for both preventive (RR = 110.8, p < .001) and rehabilitative (RR = 2.9, p < .001) services.

Participation in the check-up 45+ significantly influences the timing of preventive service applications while this effect is less pronounced for rehabilitative services.

Conclusion

This pilot strategy effectively identifies previously unrecognized needs for prevention or rehabilitation and increases service utilization. However, it primarily targets individuals with a low risk of premature workforce exit.