Effects of Inpatient Occupational Rehabilitation vs. Outpatient Acceptance and Commitment Therapy on Sick Leave and Cost of Lost Production: 7-Year Follow-Up of a Randomized Controlled Trial.

Autor: Aasdahl L; Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway. lene.aasdahl@ntnu.no.; Unicare Helsefort Rehabilitation Centre, Rissa, Norway. lene.aasdahl@ntnu.no., Gismervik SØ; Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway.; Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Johnsen R; Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway., Vasseljen O; Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway., Bjørnelv GMW; Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway.; Department of Health Management and Health Economics, Faculty of Medicine, University of Oslo, Oslo, Norway., Bjørngaard JH; Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway.; Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway., Fimland MS; Unicare Helsefort Rehabilitation Centre, Rissa, Norway.; Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.; Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Jazyk: angličtina
Zdroj: Journal of occupational rehabilitation [J Occup Rehabil] 2024 Apr 28. Date of Electronic Publication: 2024 Apr 28.
DOI: 10.1007/s10926-024-10195-x
Abstrakt: Objectives: Previously, we reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective than outpatient Acceptance and Commitment Therapy (O-ACT) in reducing sickness absence and was cost-effective over a 24-month period. Here we present 7-years of follow-up on sick leave and the cost of lost production.
Methods: We randomized individuals aged 18-60, sick-listed due to musculoskeletal or mental health disorders to I-MORE (n = 82) or O-ACT (n = 79). I-MORE, lasting 3.5 weeks, integrated ACT, physical training, and work-related problem-solving. In contrast, O-ACT mainly offered six weekly 2.5 h group sessions of ACT. We measured outcomes using registry data for days on medical benefits and calculated costs of lost production. Our analysis included regression analyses to examine differences in sickness absence days, logistic general estimating equations for repeated events, and generalized linear models to assess differences in costs of lost production.
Results: Unadjusted regression analyses showed 80 fewer days of sickness absence in the 7-year follow-up for I-MORE compared to O-ACT (95% CI - 264 to 104), with an adjusted difference of 114 fewer days (95% CI - 298 to 71). The difference in costs of production loss in favour of I-MORE was 27,048 euros per participant (95% CI - 35,009 to 89,104).
Conclusions: I-MORE outperformed O-ACT in reducing sickness absence and production loss costs during seven years of follow-up, but due to a limited sample size the results were unprecise. Considering the potential for substantial societal cost savings from reduced sick leave, there is a need for larger, long-term studies to evaluate return-to-work interventions.
(© 2024. The Author(s).)
Databáze: MEDLINE
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