Coordinated and Tailored Work Rehabilitation: A Randomized Controlled Trial with Economic Evaluation Undertaken with Workers on Sick Leave Due to Musculoskeletal Disorders

Section: Brown Et Almentioning

confidence: 99%

The EASY (Early Access to Support for You) sickness absence service: a four-year evaluation of the impact on absenteeism

Brown¹,

Mackay²,

Demou³

et al. 2015

“…Most RTW interventions focus on specific target groups, mostly sick-listed individuals with musculoskeletal health problems (3)(4)(5)(6)(7)(8)(9)(10), whereas RTW interventions addressing mental health problems are scarce (11,12). A recent systematic review of the effectiveness of RTW interventions for persons sick-listed due to musculoskeletal problems concluded that most interventions appeared beneficial.…”

mentioning

confidence: 99%

Effect of the Danish return-to-work program on long-term sickness absence: results from a randomized controlled trial in three municipalities

Poulsen¹,

Aust²,

Bjørner³

et al. 2013

This is the largest RCT ever conducted on effects of a multiple component return-to-work intervention (coordinated, tailored, and multidisciplinary). The effects of the intervention on duration of sickness absence were remarkably different between the three municipalities examined indicating that contextual factors are of major importance for success or failure of this complex intervention. 47Original article Scand J Work Environ Health. 2014;40(1):47-56. doi:10.5271/sjweh.3383 Effect of the Danish return-to-work program on long-term sickness absence: results from a randomized controlled trial in three municipalities Objectives The aim of this study was to evaluate the effect of the Danish return-to-work (RTW) program on long-term sickness absence in a randomized controlled trial in three municipalities. MethodsThe intervention group comprised 1948 participants while the control group comprised 1157 participants receiving ordinary sickness benefit management (OSM). Study participants were working-age adults receiving long-term (≥8 weeks or more) benefits, included regardless of reason for sickness absence or employment status. Each beneficiary was followed-up for a maximum period of 52 weeks. Cox proportional hazards model was used to estimate hazard ratios (HR) for return to work (RTW) with 95% confidence intervals (95% CI). ResultsThe intervention effect differed significantly between the municipalities (P=0.00005). In one municipality (M2) the intervention resulted in a statistically significant increased rate of recovery from long-term sickness absence (HR 1.51, 95% CI 1.31-1.74). In the other two municipalities, the intervention did not show a statistically significant effect (HR M1 1.12, 95% CI 0.97-1.29, and HR M3 0.80, 95% CI 0.63-1.03, respectively). Adjustment for a series of possible confounders only marginally altered the estimated HR. ConclusionThe effect of the intervention differed substantially between the three municipalities, indicating that that contextual factors are of major importance for success or failure of this complex intervention.Key terms coordinated case management; Denmark; effect evaluation; intervention; multidisciplinary; RTW; work resumption. In 2008, the annual level of sickness absence in Denmark corresponded to approximately 5% of the workforce, and reimbursement costs per year were estimated to be around €5 billion (approximately €1350 per capita age 18-64 years) not including treatment costs or loss of productivity (1). Promoting labor market participation is essential for Denmark and other European countries facing a decline in the proportion of people of working age due to an aging workforce (2). To reduce sickness absence and improve labor market participation, the Danish Government launched an action plan in 2008 encompassing 39 initiatives including the Danish returnto-work (RTW) program. The Danish National Research Centre for the Working Environment (NRCWE) was appointed to develop the program in accordance with the action plan, existing sickness management leg...

“…The Danish national RTW program is funded with 32 million euros from the Danish National Prevention Fund and 4.3 million euros from the Ministry of Employment and includes 21 of the 98 Danish municipalities. The Danish National Research Centre for the Working Environment (NRCWE) was appointed to develop the Danish RTW program in accordance with the action plan, existing sickness management legislation, and previous experiences from national and international intervention studies (9,13).…”

Section: Aust Et Almentioning

confidence: 99%

The Danish national return-to-work program – aims, content, and design of the process and effect evaluation

Aust

Helverskov

Nielsen

et al. 2012

Self Cite

The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management procedures, and (iii) a comprehensive training course for the RTW teams. The effect evaluation is based on a parallel group randomized trial and a stratified cluster-controlled trial and focuses on register-based primary outcomes -duration of sickness absence and RTW -and questionnaire-based secondary outcomes such as health and workability. The process evaluation utilizes questionnaires, interviews, and municipal data. The effect evaluation tests whether participants in the intervention have a (i) shorter duration of full-time sickness absence, (ii) longer time until recurrent long-term sickness absence, (iii) faster full RTW, (iv) more positive development in health, workability, pain, and sleep; it also tests whether the program is (v) cost-effective. The process evaluation investigates: (i) whether the expected target population is reached; (ii) if the program is implemented as intended; (iii) how the beneficiaries, the RTW teams, and the external stakeholders experience the program; and (iv) whether contextual factors influenced the implementation.The program has the potential to contribute markedly to lowering human and economic costs and increasing labor force supply. First results will be available in 2013. The trial registrations are ISRCTN43004323, and ISRCTN51445682.