Effectiveness of the Coordinated Return to Work model after orthopaedic surgery for lumbar discectomy and hip and knee arthroplasty: a register-based study.

Autor:	Lavikainen P; School of Pharmacy, University of Eastern Finland, Kuopio, Finland piia.lavikainen@uef.fi., Heiskanen J; School of Pharmacy, University of Eastern Finland, Kuopio, Finland., Jalkanen K; School of Pharmacy, University of Eastern Finland, Kuopio, Finland., Lehtimäki AV; School of Pharmacy, University of Eastern Finland, Kuopio, Finland., Vehkala S; School of Pharmacy, University of Eastern Finland, Kuopio, Finland., Kangas P; Finnish Institute of Occupational Health, Helsinki, Finland., Husman K; University of Eastern Finland, Kuopio, Finland., Vohlonen I; Department of Public Health, University of Eastern Finland, Kuopio, Finland., Martikainen J; School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Jazyk:	angličtina
Zdroj:	Occupational and environmental medicine [Occup Environ Med] 2024 Mar 08; Vol. 81 (3), pp. 150-157. Date of Electronic Publication: 2024 Mar 08.
DOI:	10.1136/oemed-2023-109276
Abstrakt:	Objectives: This study examined the effectiveness of an individualised Coordinated Return to Work (CRtW) model on the length of the return to work (RTW) period compared with a standard prescription of 2-3 months RTW during recovery after lumbar discectomy and hip and knee arthroplasty among Finnish working-age population. Methods: Cohorts on patients aged 18-65 years old with lumbar discectomy or hip or knee arthroplasty were extracted from the electronic health records of eight Finnish hospital districts in 2015-2021 and compiled with retirement and sickness benefits. The overall effect of the CRtW model on the average RTW period was calculated as a weighted average of area-specific mean differences in RTW periods between 1 year before and 1 year after the implementation. Longer-term effects of the model were examined with an interrupted time series design estimated with a segmented regression model. Results: During the first year of the CRtW model, the average RTW period shortened by 9.1 days (95% CI 4.1 to 14.1) for hip arthroplasty and 14.4 days (95% CI 7.5 to 21.3) for knee arthroplasty. The observed differences were sustained over longer follow-up times. For lumbar discectomy, the first-year decrease was not statistically significant, but the average RTW had shortened by 36.2 days (95% CI 33.8 to 38.5) after 4.5 years. Conclusions: The CRtW model shortened average RTW periods among working-age people during the recovery period. Further research with larger samples and longer follow-up times is needed to ensure the effectiveness of the model as a part of the Finnish healthcare system. Competing Interests: Competing interests: JM is a founding partner of ESiOR Oy. This company was not involved in carrying out this research. PL, JH, KJ, A-VL, SV, PK, KH and IV declare no conflicts of interest. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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