Early workplace intervention for employees with musculoskeletal-related absenteeism:: A prospective controlled intervention study

被引:115
作者
Arnetz, BB [1 ]
Sjögren, B
Rydéhn, B
Meisel, R
机构
[1] Univ Uppsala, Sect Social Med, Dept Publ Hlth & Caring Sci, S-75185 Uppsala, Sweden
[2] Univ Uppsala, CEOS, Ctr Environm Ilness & Stress, S-75185 Uppsala, Sweden
[3] Skogas Forsakringskassa, S-14281 Skogas, Sweden
[4] A Rehab Inc, S-11638 Stockholm, Sweden
关键词
D O I
10.1097/01.jom.0000063628.37065.45
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Sickness absenteeism caused by musculoskeletal disorders (MSDs) is a persistent and costly occupational health challenge. In a prospective controlled Mal, we compared the effects on sickness absenteeism of a more proactive role for insurance case managers as well as workplace ergonomic interventions with that of traditional case management. Patients with physician-diagnosed MSDs were randomized either to the intervention group or the reference group offered the traditional case management routines. Participants filled out a comprehensive questionnaire at the initiation of the study and after 6 months. In addition, administrative data were collected at 0, 6, and 12 months after the initiation of the project. For the entire 12-month period, the total mean number of sick days for the intervention group was 144.9 (SEM 11.8) days,person as compared to 197.9 (14.0) days in the reference group (P < 0.01). Compared with the reference group, employees in the intervention group significantly more often received a complete rehabilitation investigation (84% versus 27%). The time for doing this was reduced by half (59.4 (5.2) days versus 126.8 (19.2), P <.01). The odds ratio for returning to work in the intervention group was 2.5 (95% confidence interval 1.2-5.1) as compared with the reference group. The direct cost savings were USD 1195 per case, yielding a direct benefit-to-cost ratio of 6.8. It is suggested that the management of MSDs should to a greater degree focus on early return to work and building on functional capacity and employee ability. Allowing the case managers a more active role as well as involving an ergonomist in workplace adaptation meetings might also be beneficial.
引用
收藏
页码:499 / 506
页数:8
相关论文
共 23 条
[1]   Staff perception of the impact of health care transformation on quality of care [J].
Arnetz, BB .
INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, 1999, 11 (04) :345-351
[2]   Psychosocial challenges facing physicians of today [J].
Arnetz, BB .
SOCIAL SCIENCE & MEDICINE, 2001, 52 (02) :203-213
[3]   PSYCHOSOCIAL PREDICTORS OF OUTCOME IN ACUTE AND SUBCHRONIC LOW-BACK TROUBLE [J].
BURTON, AK ;
TILLOTSON, KM ;
MAIN, CJ ;
HOLLIS, S .
SPINE, 1995, 20 (06) :722-728
[4]   Determinants of self rated health for Canadians with chronic disease and disability [J].
Cott, CA ;
Gignac, MAM ;
Badley, EM .
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 1999, 53 (11) :731-736
[5]   A controlled trial of an educational program to prevent low back injuries [J].
Daltroy, LH ;
Iversen, MD ;
Larson, MG ;
Lew, R ;
Wright, E ;
Ryan, J ;
Zwerling, C ;
Fossel, AH ;
Liang, MH .
NEW ENGLAND JOURNAL OF MEDICINE, 1997, 337 (05) :322-328
[6]  
FRYMOYER JW, 1991, ORTHOP CLIN N AM, V22, P263
[7]   Length of disability and cost of workers' compensation low back pain claims [J].
Hashemi, L ;
Webster, BS ;
Clancy, EA ;
Volinn, E .
JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE, 1997, 39 (10) :937-945
[8]   Systematic review of psychosocial factors at work and private life as risk factors for back pain [J].
Hoogendoorn, WE ;
van Poppel, MNM ;
Bongers, PM ;
Koes, BW ;
Bouter, LM .
SPINE, 2000, 25 (16) :2114-2125
[9]  
KARJALAINEN K, 2000, COCHRANE DATABASE SY, V3
[10]   STANDARDIZED NORDIC QUESTIONNAIRES FOR THE ANALYSIS OF MUSCULOSKELETAL SYMPTOMS [J].
KUORINKA, I ;
JONSSON, B ;
KILBOM, A ;
VINTERBERG, H ;
BIERINGSORENSEN, F ;
ANDERSSON, G ;
JORGENSEN, K .
APPLIED ERGONOMICS, 1987, 18 (03) :233-237