Abstract
BACKGROUND: The guiding principle of disability insurance in Switzerland is 'rehabilitation before pension'. Access to rehabilitation measures to restore, maintain or improve the earning capacity of individuals with disabilities is essential. Gainful employment enables them to be an active part of society, improves their quality of life, and may mitigate the adverse health effects of disability pension receipt. The aim of this study was therefore to identify factors for disability insurance benefit application in Switzerland. METHODS: A novel dataset was created linking the 2010 Social Protection and Labour Market cross-section with administrative register data on disability insurance benefit application (2009-2018). Multiple logistic regression was employed to examine the associations between long-term health-related activity limitation, region of residence, demographic and socioeconomic characteristics and disability insurance benefit application in adults aged 18-55 (N = 18,448). Sensitivity analysis based on age was performed in individuals aged 18 to retirement age and aged 25 to 55. RESULTS: The regression results showed higher odds of disability insurance benefit application for individuals suffering from long-term health-related activity limitations (OR 2.88; 95% CI 1.29-6.44; p-value 0.010); born outside of Switzerland (OR 1.75; 95% CI 1.32-2.32; p-value 0.000); living without a working partner (OR 1.54; 95% CI 1.17-2.02; p-value 0.002); living without a child aged 0-14 years (OR 1.70; 95% CI 1.29-2.26; p-value 0.000); aged 18-39 (OR 1.41; 95% CI 1.09-1.83; p-value 0.009); with a learnt occupation in 'Manufacturing' (OR 2.75; 95% CI 1.68-4.50; p-value 0.000), 'Construction and mining' (OR 2.03; 95% CI 1.13-3.66; p-value 0.018), 'Trade and transport' (OR 2.12; 95% CI 1.30-3.45; p-value 0.003), 'Business and administration' (OR 1.68; 95% CI 1.03-2.72; p-value 0.036), and 'Health, teaching, culture and science' (OR 1.55; 95% CI 1.05-2.29; p-value 0.026); and renters (OR 1.44; 95% CI 1.00-1.94; p-value 0.016). The results were robust to alternative samples defined by age - albeit with some differences in regional and learnt occupational patterns. CONCLUSIONS: The results suggested that disability insurance benefit application is more than a health-related phenomenon in Switzerland. However, the results provided a less consistent picture on the role of marginalization in application than in other European countries.