title: Effects of co-financed interdisciplinary teamwork on sick leave for people with musculoskeletal disorders.
abstract: OBJECTIVE
  The aim of the study was to assess if health care centres with a co-financing model for collaborative rehabilitation between primary health care, sickness insurance offices and social welfare offices reduced sick leave among persons with musculoskeletal disorders compared to health centres with conventional rehabilitation structures.
  
  
  METHODS
  A comparative prospective study was conducted. Consecutive patients aged 16-64 with musculoskeletal disorders attending the health care centres with (n=107) and without (n=31) co-financing model were interviewed. In addition, we collected register data about patients' allowances for sick leave days for totally 18 months.
  
  
  RESULTS
  The intervention group had an average of 94 days and the controls 87 days on sick leave during the 12-months period after inclusion in the study. At 12 months the proportion of patients sick listed was 31% in the intervention group and 32% in the control group.
  
  
  CONCLUSIONS
  The study could not show that the co-financing model reduced the numbers of sick leave days among patients with musculoskeletal disorders. A possible explanation for the lack of positive impact on patients' health or work ability might be that the working procedure has in fact not really been changed and the tool mix lack solid evidence. The study identifies some methodological problems addressed in future research trying to link organisational changes with patient outcomes.
authors.affiliation: Department of Social Medicine, The Sahlgrenska Academy at Göteborg University, Sweden. eva-lisa@hultberg@socmed.gu.se
authors.forename: Eva-Lisa
authors.initials: EL
authors.lastname: Hultberg
authors.forename: Knut
authors.initials: K
authors.lastname: Lönnroth
authors.forename: Peter
authors.initials: P
authors.lastname: Allebeck
authors.forename: Gunnel
authors.initials: G
authors.lastname: Hensing
mesh_terms: D000293:Adolescent; D000328:Adult; D003299:Cooperative Behavior; D005260:Female; D006268:Health Facilities; D006801:Humans; D007348:Insurance, Health; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases; D011446:Prospective Studies; D012047:Rehabilitation Centers; D018582:Sick Leave / Q000639:trends*; D014481:United States