Implementation of a Return to Work Strategy in Germany—Are There Changes in Work-Related Rehabilitation Measures and Employment Status in Chronic Conditions?

Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants with chronic conditions. The objective was to identify the degree of implementation of work related measures in medical rehabilitation and the extent of RTW outcomes. Methods: 5883 insurants were considered. Severe Restriction of Work Ability (SRWA), Work-related Medical Rehabilitation (WMR), and Case Management (CM) were examined for 2008 and 2012. An Index of Employment status (IoE) was used in a logistic regression. Results: Utilization of WMR raised from 12.3% in 2008 to 66.1% in 2012. The proportion of insurants with SRWA and WMR grew from 8% up to 40.1%. In 2008, 14.7% of insurants with SRWA received WMR;in 2012, it grew to 76.6%. On the other hand, in 2012 26% got WMR without SRWA and 12.2% had SRWA and got no WMR. CM was not conducted in 2008 but reached 20.2% in 2012. Across all indications, WMR resulted in positive RTW as measured by IoE: OR = 0.75 (KI-95%: 0.67 - 0.86). Conclusion: WMR was successfully implemented according to the German guideline. There is a need to optimize the linkage between SRWA and WMR and CM to provide need-based care.

Bi-level Coordinated Planning of Active Distribution Network Considering Demand Response Resources and Severely Restricted Scenarios

Due to the uncertainty and fluctuation of distributed generation(DG)and load,the operation of active distribution network(ADN)is affected by multi-dimension factors which are described by massive operation scenarios.Efficient and accurate screening of severely restricted scenarios(SRSs)has become a new challenge in ADN planning.In this paper,a novel bi-level coordinated planning model which combines the short-time-scale operation problem with the long-time-scale planning problem is proposed.At the upper level,the demand response(DR)resource,an effective non-component planning resource characterized by low capacity price,high energy price,and short contract term,is co-optimized with the configuration of lines and energy storage systems(ESSs)to achieve the economic trade-off between the investment cost and the operation cost under SRSs.At the lower level,with the planning scheme obtained from the upper level,massive operation problems are optimized to minimize the daily operation cost;and the SRSs are provided to the upper level through a shadow-price-based scenario screening method,which simulates the planning information(i.e.,the restricted degrees of operation scenarios)feedback process from ADN operators to ADN planners.Case studies on a 62-node distribution system in Jianshan New District,Zhejiang Province,China,illustrate the effectiveness of the proposed bi-level coordinated planning model considering DR resources and SRSs.