Article type
Year
Abstract
Background: workers on long-term sick leave run a large risk of unemployment and remaining outside the labour market. Interventions that focus on communication and co-operation between stakeholders are popular interventions to support the return-to-work (RTW) process but a Cochrane Systematic Review found no significant differences on RTW outcomes between RTW co-ordination programmes and usual practice in workers at risk for long-term disability.
Objectives: to evaluate how current practice in RTW co-ordination in Finland conforms with the evidence on its effectiveness and needs to be de-implemented.
Methods: we used triangulation to analyse similarities and discrepancy between the results from the review and current practice in Finland. We performed a document analysis of relevant publications about RTW co-ordination practice in Finland and two online surveys with experts. We used predefined categories to extract and compare data from the review, the literature and the survey results. We drafted two scenarios to evaluate the costs of RTW co-ordination programmes compared to usual interventions without co-ordination.
Results: we included documents and data from 10 survey participants in the analysis. We found no difference between the interventions included in the review and practice in Finland. RTW co-ordination programmes included at least one face-to-face meeting with the co-ordinator and the worker, a workers’ needs assessment, an individual RTW plan, and the management of the implementation of the plan. In contrast, usual care interventions provided no individual tailored RTW plan to the worker and the workers’ needs assessment did not include considerations of the work or the workplace. Usual care interventions focused on medical care and could also include help with RTW, but only as general advice to resume work when possible. Currently, the evidence on the effectiveness of the intervention is of very low to moderate quality and so future, better-quality studies may change the results. We found that RTW co-ordination programmes are not cost-effective in decreasing sick-leave compared to usual care.
Conclusions: currently available evidence does not support further investment in the development and implementation of RTW co-ordination programmes. If this evidence is not sufficient to convince stakeholders to de-implement the intervention, the most rational option is to fund a high-quality evaluation study with long-term follow-up.
Patient or healthcare consumer involvement: the Finnish Institute of Occupational Health is an independent research organisation entrusted by not only the government but also the workers’ and the employers’ unions to study and promote the health and safety of workers. This arrangement ensures on a strategic level that our research output is highly relevant to workers, employers and society at large.
Objectives: to evaluate how current practice in RTW co-ordination in Finland conforms with the evidence on its effectiveness and needs to be de-implemented.
Methods: we used triangulation to analyse similarities and discrepancy between the results from the review and current practice in Finland. We performed a document analysis of relevant publications about RTW co-ordination practice in Finland and two online surveys with experts. We used predefined categories to extract and compare data from the review, the literature and the survey results. We drafted two scenarios to evaluate the costs of RTW co-ordination programmes compared to usual interventions without co-ordination.
Results: we included documents and data from 10 survey participants in the analysis. We found no difference between the interventions included in the review and practice in Finland. RTW co-ordination programmes included at least one face-to-face meeting with the co-ordinator and the worker, a workers’ needs assessment, an individual RTW plan, and the management of the implementation of the plan. In contrast, usual care interventions provided no individual tailored RTW plan to the worker and the workers’ needs assessment did not include considerations of the work or the workplace. Usual care interventions focused on medical care and could also include help with RTW, but only as general advice to resume work when possible. Currently, the evidence on the effectiveness of the intervention is of very low to moderate quality and so future, better-quality studies may change the results. We found that RTW co-ordination programmes are not cost-effective in decreasing sick-leave compared to usual care.
Conclusions: currently available evidence does not support further investment in the development and implementation of RTW co-ordination programmes. If this evidence is not sufficient to convince stakeholders to de-implement the intervention, the most rational option is to fund a high-quality evaluation study with long-term follow-up.
Patient or healthcare consumer involvement: the Finnish Institute of Occupational Health is an independent research organisation entrusted by not only the government but also the workers’ and the employers’ unions to study and promote the health and safety of workers. This arrangement ensures on a strategic level that our research output is highly relevant to workers, employers and society at large.
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