The effects of timing on the cost-effectiveness of interventions for workers on sick leave due to low back pain

Duijn, Miranda van; Eijkemans, Marinus J.C.; Koes, Bart W.; Koopmanschap, Marc; Burton, Kim; Burdorf, Alex

doi:10.1136/oem.2009.049874

Cited by 39 publications

(34 citation statements)

References 37 publications

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“…This timeframe is very similar to the timing used in the present study (most participants were included at between 8-10 weeks of sickness absence benefits). However, it should be recognized that the RTW recovery rate in the present study was far lower than the recovery rate characterized as slow in the study on RTW and lowback pain (21).…”

Section: Discussioncontrasting

confidence: 74%

“…However, at later stages of the absence spells, when only more complex cases are under consideration (under the assumption that the most straightforward cases have been solved and closed), the effect of the CTM intervention might become superior to OSM, leading to a statistically significant HR for spells that lasted >42 weeks in M1. It has been recently demonstrated that timing is crucial for the cost-effectiveness of structured and complex interventions for workers on sick leave due to low-back pain (21). Using theoretical modeling, the authors estimated the optimal time window to be between 8-12 weeks for a population with a slow RTW (RTW of 43% after 2 weeks and 79% after 12 weeks).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Scand J Work Environ Health

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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...

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

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

Scand J Work Environ Health

View full text Add to dashboard Cite

show abstract

“…Many studies have evaluated the effectiveness of return to work (RTW) interventions after injury and illness (12)(13)(14)(15)(16)(17)(18)(19)(20)(21). These have ranged from minimal postal intervention, OH phone intervention to multidisciplinary approaches involving workplace assessment, work modifications and importantly case management involving all stakeholders (22)(23)(24)(25).…”

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

Scand J Work Environ Health

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“…The effects were in general modest: mean reduction in sickness absence being only 1.1 days per month -and even lower in higher quality studies -and similar between the different types of interventions. Van Duijn et al (8) looked at the effects of different timing of structured interventions on RTW. They modeled gained sickness absence days with differently timed interventions among populations with expected fast or slow RTW.…”

Section: Viikari-juntura Et Almentioning

confidence: 99%

“…However, recent systematic reviews (7) and economic analyses (8) have emphasized that few have proven to be cost-effective. It has been difficult to find costeffective solutions for RTW especially at the early stage of disability.…”

Section: Control Group Intervention Groupmentioning

confidence: 99%

Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial

Viikari‐Juntura¹,

Kausto²,

Shiri³

et al. 2011

Scand J Work Environ Health

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The effects of timing on the cost-effectiveness of interventions for workers on sick leave due to low back pain

Cited by 39 publications

References 37 publications

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

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

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

Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial

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