[Offering multidisciplinary medical rehabilitation to workers with work disability due to musculoskeletal disorders: results of randomized controlled trial].
OBJECTIVE
In Germany medical rehabilitation has to be initiated by members of statutory pension fund and health insurances. This often leads to delays in the application for and provision of rehabilitation services. Since January 2000 a regional statutory pension fund for blue collar workers (LVA Schleswig-Holstein), 4 statutory health insurances and their medical service MDK have been evaluating a pro-active system to offer rehabilitation to certain member groups. Its acceptance, performance and outcomes were evaluated within a randomized controlled study.


METHODS
Over one year actively insured (i. e. working) members of the a. m. institutions were screened for longer work disability due to musculoskeletal disorders (ICD-10: M05 - 25, M40 - 54, M60 - 99). Based on further inclusion criteria eligible persons were randomized either to an intervention (invitation, counselling, application support) or control (usual care) group. At baseline and six and 12 months all participants completed a postal questionnaire enquiring about various health status aspects (secondary outcomes). Information on sick leave (cases, days), hospital treatment and disability pension was based on administrative data (primary outcomes). Analyses were run on an intention to treat-, per protocol-, as actual-, and matched pairs-basis.


RESULTS
230 persons gave written informed consent (IG: n = 134, KG: n = 96). Within 6 months after study entry 69% of the IG- and 20 % of the KG-members participated in a 3 week in-patient multidisciplinary rehabilitation program. Compared to 6 months prior to the study the occurrence of sick leave due to musculoskeletal disorders was clearly reduced during follow-up between month 6 and 12, however with no significant difference between the two groups. Additionally, IG and CG did not differ in any other primary and secondary outcomes.


CONCLUSIONS
Contrary to our expectations the IG-members do not seem to benefit from the PETRA-programme including inpatient rehabilitation.
Hüppe
A
A
Institut für Sozialmedizin der Universität zu Lübeck. angelika.hueppe@sozmed.uni-luebeck.de
Glaser-Möller
N
N
Raspe
H
H
D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods / Q000706:statistics & numerical data*; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000534:rehabilitation*; D009788:Occupational Therapy / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D018582:Sick Leave / Q000706:statistics & numerical data*; D016896:Treatment Outcome