A041 Impact of Early Retirement in Germany

1. Consequences of demographic
change on rehabilitation in German
Pension Insurance
Uwe Egner, Stephan Mäder, Nadine Vorsatz
German Federal Pension Insurance (Deutsche Rentenversicherung Bund)
23rd
Rehabilitation International World Congress
25th
of October – 27nd
of October 2016, Edinburgh, Scotland
1

2. Agenda
1. German Federal Pension Insurance (GFPI) – the institution
2. Background
1. Population development
2. Routine data from GFPI
3. Study: WOMR-Management
1. Results
4. Conclusions
2

3. German Federal Pension Insurance
- the institution
Public service provider in the field of social security
More than 18,000,000 insured people
Tasks and benefits:
• Rehabilitation (medical and vocational)
• Pension payments (retirement pensions and pensions due to
reduced earning capacity)
Funded by contributions of employers and employees
Responsible for insured people all over Germany
3

4. Key figures
medical rehabilitation
Source: ISRV claims for rehabilitation Tab.: 001.1, INFOSYS § 3 RSVwV A+E
Claims and Approvals
661,376
717,818
744,824 765,405 780,312 791,511 792,196 771,415 786,135
759,332
426,087 446,623 465,235 486,690 479,900 492,959 488,812 470,765 493,783 475,003
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Claims DRV Bund Approvals DRV Bund
4

5. Key figures
expenses for rehabilitation 2015
medical rehabilitation
vocational rehabilitation
benefits paid in place of salary
and social security fees
refunds and other
Total: 2,615 million euro *
1,740 million euro
279 million euro
602 million euro
Source: AL 8000* gross without refunds and allowances | expected annual earnings 2015 (02nd
of February 2016)
-6 million euro
5

6. Development of population 2013 - 2030
Source: Destatis Bevölkerungspyramide 13.koordinierte Bevölkerungsvorausberechnung
6

7. Proportions of different age groups in the
population (in millions)
variant 1-W1
age group
total
AQ
<20 20-65 65+
2013 14.7 49.2 16.9 80.8 34.0
2030 13.8 43.6 21.8 79.2 50.0
Assumptions : birth rate approximately constant at 1.4 children per woman
Life expectancy at birth in 2060:
84.8 years for boys
88,8 years for girls
yearly migration balance (from 2021) + 100 000 persons
Source: Destatis Bevölkerungspyramide 13.koordinierte Bevölkerungsvorausberechnung
7

8. 38.3
45.6
53.8
57 58
70.1
45.6
50.1
63.5 61.7 59.8
73.6
0
10
20
30
40
50
60
70
80
F EU-28 D DK GB S
2008 2013
Good news:
Employment rate 55 to 64 years in Germany
above the average of the EU
Source: Eurostat, 2015
proportion of older employees in percent
8

9. Average age of retirement due to old age
60.0
61.0
62.0
63.0
64.0
65.0
66.0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
men women
averageage(years)
Source: ISRV Tab.: 102.00 Z RV
9

10. 45.0
46.0
47.0
48.0
49.0
50.0
51.0
52.0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
men women
Average age of retirement
due to reduced earning capacity
Source: ISRV Tab.: 102.00 Z RV
averageage(years)
10

11. 0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
men women
Retirement due to reduced earning capacity
- Musculoskeletal diseases system and
connective tissue
Source: Rentenversicherung in Zeitreihen Oktober 2014
numbers
11

12. 0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
men women
Source: Rentenversicherung in Zeitreihen Oktober 2014
Retirement due to reduced earning capacity
Mental and behavioural disorders
12
numbers

13. Developments in medical rehabilitation
- Average age of the rehabilitees
Mental and behavioural disorders
44.2 44.2 44.4
44.9
45.2
45.8
46.1
46.5
46.9
47.3
40
41
42
43
44
45
46
47
48
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Source: ISRV Tab.: 07+16.00 M RV
13

14. 49.5 49.7 49.9
50.3
50.6
51
51.4
51.8
52.1
52.4
45
46
47
48
49
50
51
52
53
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Source: ISRV Tab.: 16.00 M RV
Developments in medical rehabilitation
- Average age of the rehabilitees
Orthopedics
14

15. Approvals
Medical rehabilitation
- Approvals by age
Source: Infosys web
0
20,000
40,000
60,000
80,000
100,000
< 20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 >65
age (years)
2009 2015
2009: n = 486,690, 2015: n = 475,003
15

16. Prediction of develoment of
medical rehabilitation
German Federal Pension Insurance (total)
Source: RSD, inkl. AHB, abgeschl. Reha, * hochgerechnet
2014: n = 1.008.050, 2018: n = 1.055.830
Rehabilitation
2007 – 2014*
Prediction
2015 - 2018
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
+ 4,7%
2014* - 2018
16

17. Needs for orientation
in medical rehabilitation
Source: Re-Analyse MBO-Studie (Streibelt 2009)
Patient survey before starting orthopedic rehabilitation:
What do you think will
help you most during
rehabilitation?
17

18. Needs for orientation
in medical rehabilitation
80%
10%
25%
23%
87%
11%
64%
41%
35%
69%
0% 20% 40% 60% 80% 100%
gymnastics / sports
worktherapy /
ergotherapy
relaxation therapy
occupational
consultation
occupational
therapy
<=50 years n= 981
>50 years n= 630
Source: Re-Analyse MBO-Studie (Streibelt 2009) 18

19. Patient survey
Source: Re-Analyse MBO-Studie (Streibelt 2009)
Patient survey after finishing a somatic rehabilitation:
Did you receive
consultations and help in
the rehab-center to
facilitate the situation at
your workplace or to return
to work?
19

20. Item S50
Patient survey
Situation at workplace or return to work
59%
41%
69%
31%
0% 20% 40% 60% 80% 100%
no
yes
>50 years n=11.088
<=50 years n=11.797
Source: Befragungszeitraum II/2007 + I/2008
20

21. 21
0
0,2
0,4
0,6
0,8
1
0 500 1000 1500 2000
Tage bis Rentenzugang
KumuliertesÜberleben
T-Wert bis 40
T-Wert größer 40 bis 60
T-Wert größer 60
Risk-Index for reduced earning capacity
pensions
Quelle: Bethge et al. 2011
Goal: Prediction of early retirement (ER)
Principle: Scale of 0 to 100 points, consisting of contributions of the last
3 years (amount and origin) and sociodemographic factors
Risk of ER:
30 times higher
Risk of ER:
6 times higher
Hit rate of ER:
74 %
Nearly 90% in ER
after 5 years!
VerbleibimErwerbsleben

22. 31%
0% 0%
8%
12%
0% 0%
19%
13%
32%
0%
5%
63%
0%
72%
0%
19%
13%
75%
1%
0%
12%
68%
11%
43%
0%
20%
40%
60%
80%
100%
continous
Contributions to
pension insurance
temporary
contributions
early retirement retirement death
<= 29 years, n=4.705
30-39 years, n=13.537
40-49 years, n=37.737
50-59 years, n=44.095
> 60 years, n=7.349
Benefit of rehabilitation
Payment of contributions - two years follow up
Rehab caused by mental and behavioural disorders
Source: RSD 2005-2012
!

Compulsorily insured persons, who finished medical rehabilitation
in 2010
22

23. Conclusions
Ageing workforce leads to older clients in rehab-centers
Risk of reduced earning capacity must be main focus of Pension
Insurance and rehab-centers
Services for older patients must be focused strictly on return to work
Workplace orientated rehabilitation as a main focus for German
Pension Insurance
23

24. Impressum
23rd Rehabilitation International World Congress
25th of October – 27nd of October 2016, Edinburgh, Scotland
Consequences of demographic
change on rehabilitation in German
Pension Insurance
Uwe Egner
German Federal Pension Insurance
24