Are the dimensions of positive health associated with work participation and receiving disability benefit? A cross-sectional study in outclinic patients with chronic gastrointestinal disorders

Objective To describe work participation (WP) and receiving disability benefit (DB) in persons with chronic gastrointestinal disorders (CGID); to describe associations between the six dimensions of positive health (PH) and WP and DB, respectively; and to assess whether the type of CGID is associated with WP and receiving DB. Design Cross-sectional and observational questionnaire study. Setting Maastricht University Medical Centre+ (tertiary care hospital), including regional, supra-regional and national referrals. Participants 441 patients of working age (18-66 years) with CGID who visited the outpatient department of the Gastroenterology-Hepatology Clinic between March 2019 and June 2021 (mean +/- SD age: 45.0 +/- 14.7 years, 68.5% women). Primary/secondary outcome measures Associations of PH dimensions and WP and receiving DB, respectively; association of type of CGID and WP, and receiving DB. The main independent variables (PH dimensions) were bodily functions, mental well-being, meaningfulness, quality of life (QoL), participation and daily functioning. Results Among 441 working-age patients, 49% worked; 20% received DB (40% of non-workers). All PH dimensions related significantly to WP and DB (bivariate level). After adjusting for demographics and CGID type, better general health (dimension QoL) (OR 1.018; 95% CI 1.001 to 1.035, p=0.040) and daily functioning dimension (OR 1.030; 95% CI 1.013 to 1.047, p<0.001) related to higher WP. In the fully adjusted model, daily functioning showed the strongest association with receiving DB. Each one-point increase in Short Form-36 physical functioning was associated with a 2% lower likelihood of receiving DB (OR 0.975; 95% CI 0.959 to 0.992; p=0.004). Conclusions Of the 441 working-age patients with CGID, only 49% worked; most non-workers did not receive DB. Of the PH dimensions, daily functioning appears most directly related to WP and receiving DB; CGID type had minimal impact.