title: Systematic co-operation between employer, occupational health service and social insurance office: a 6-year follow-up of vocational rehabilitation for people on sick-leave, including economic benefits.
abstract: OBJECTIVE
  To evaluate the effects of systematic co-operation among municipal employees on the number of sick-leave days per month and the type of benefit granted by the Social Insurance Office. A further aim was to evaluate the economic consequences for society.
  
  
  METHODS
  A 6-year follow-up study with a matched-pairs design.
  
  
  METHODS
  Days on sick-leave were calculated for each subject one year before the intervention started and yearly for the following 6-year period. Statistical mixed-model analysis was used. The economic benefit of the intervention was estimated as the increased production stemming from fewer days on sick-leave.
  
  
  METHODS
  Sixty-four employees on long-term sick-leave were individually matched with controls from another Social Insurance Office in a county with a socioeconomic structure similar to that of the study group.
  
  
  RESULTS
  The study group had 5.7 fewer days on sick-leave per month and person over the 6-year period (p=0.003). The estimated average economic benefit of the intervention was euro36,600 per person over the 6-year period. In conclusion, those who received systematic co-operation in vocational rehabilitation had fewer days on sick-leave than their "treatment-as-usual" peers. This effect persisted over 6 years, generating substantial net economic gains for society.
authors.affiliation: Department of Rehabilitation Medicine, Danderyd Hospital, Building 39, 3rd floor, SE 182 88 Stockholm, Sweden. jenny.karrholm@ki.se
authors.forename: Jenny
authors.initials: J
authors.lastname: Kärrholm
authors.forename: Karolina
authors.initials: K
authors.lastname: Ekholm
authors.forename: Jan
authors.initials: J
authors.lastname: Ekholm
authors.forename: Alf
authors.initials: A
authors.lastname: Bergroth
authors.forename: Kristina Schüldt
authors.initials: KS
authors.lastname: Ekholm
mesh_terms: D003362:Cost-Benefit Analysis; D004651:Employment; D005500:Follow-Up Studies; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008137:Longitudinal Studies; D009786:Occupational Health Services / Q000191:economics / Q000458:organization & administration; D012050:Rehabilitation, Vocational / Q000191:economics; D018582:Sick Leave / Q000191:economics; D012943:Social Security / Q000191:economics; D012959:Socioeconomic Factors; D013548:Sweden