Introduction In Germany the statutory pension insurance fund covers the cost of rehabilitation treatment for employees whose working capacity is endangered due to health problems.

Objectives We aimed to describe success of medical rehabilitation (work ability at discharge, return to work in the year after rehabilitation, early retirement within seven years after rehabilitation) with special consideration of potential sociodemographic determinants among employed persons undergoing medical rehabilitation from 2010 to 2012 in Germany.

Methods Analysis based on Scientific Use Files of administrative pension records from the Research Data Centre of the German Federal Pension Insurance, which include 20 percent random samples of all cases of medical rehabilitation. Risk of low work ability at discharge (LWA) and failed return to work in the year after rehabilitation (FRW) was estimated using logistic regression models, risk of early retirement during seven years after rehabilitation (ER) was estimated using cox proportional hazard models. Age, sex, citizenship, school and vocational education, annual income before rehabilitation and medical diagnosis were considered as potential risk factors.

Results We included 185.385 employed persons aged 18 to 60 years undergoing medical rehabilitation from 2010 to 2012. Low work ability at the end of rehabilitation was reported among 7.9%, 26% showed unsufficient return to work one year after rehabilitation, and 9.7% received disability pension during 7-year follow-up, respectively. In fully adjusted models, non-German citizenship, older age, low educational level, as well as low annual income were risk factors for each outcome of work ability. For example, adjusted risk among persons with low annual income (1st quartile vs. 4th quartile, OR/HR [95%-CI]) was 2.3 [2.2;2.4] for FRW, 4.8 [4.5; 5.1] for LWA, and 2.5 [2.3; 2.6] for ER.

Conclusions These results continue to show that success of medical rehabilitation is lower in deprived social groups in Germany.