Home health equipment maker Invacare (NYSE:IVC) is laying off about 50 workers worldwide, citing a difficult economy and declining reimbursements to its customers. The layoffs are primarily hitting office workers and affect less than 1 percent of the Elyria, Ohio-based company’s 6,200 global workers, spokeswoman Lara Mahoney said. Mahoney partially blamed the layoffs on falling reimbursements to nursing homes and other home medical equipment buyers. “We’re just ensuring that we’re running as efficiently as possible,” she said. “We’re hiring in some positions and having to make tough decisions in others.”