title: Locking-in effects due to early interventions? An evaluation of a multidisciplinary screening programs for avoiding long-term sickness.
abstract: OBJECTIVE
  In this article, we estimate the effect of a multidisciplinary collaborationprogram on the length of sickness absence. The intention with the programwas to avoid long-term sickness absence by providing an early and holistic evaluation of the sick-listed individuals' conditions. The target group was individuals who were at risk of becoming long-term sick. The eligibility criteria were mainly based on register information that we have access to.
  
  
  METHODS
  Using this register information, we estimate different Cox regression models and apply a nonparametric matching estimator. We have also conducted a small randomized experiment.
  
  
  RESULTS
  The result from the randomized experiment is not statistically significant, but the point estimate provides the same result as was found in the observational study: The program prolongs rather than shortens the sickness absence spell. That is, the average sickness absence spell is prolonged by about 3 months.
  
  
  CONCLUSIONS
  Our main explanation for this discouraging result is that the team focuses too much on rehabilitation rather than encouraging the sick-listed individual to return to work.
authors.affiliation: IFAU, Uppsala, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Johansson
authors.forename: Erica
authors.initials: E
authors.lastname: Lindahl
mesh_terms: D000328:Adult; D005260:Female; D006302:Health Services Research; D006694:Holistic Health; D006801:Humans; D008297:Male; D008403:Mass Screening; D009784:Occupational Diseases / Q000453:epidemiology / Q000534:rehabilitation*; D011320:Primary Health Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D062707:Return to Work; D018582:Sick Leave / Q000706:statistics & numerical data*; D012947:Social Work; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome