2012-10-01 12:00 - Messages

The effect of ill health and socioeconomic status on labor force exit and re-employment: a prospective study with ten years follow-up in the Netherlands

Objectives: The aim of this study was to investigate the effect of ill health and socioeconomic status on labor force exit due to unemployment, early retirement, disability pension, or becoming economically inactive. A secondary objective was to investigate the effect of ill health and socioeconomic status on return to work. Methods A representative sample of the Dutch working population (N=15 152) was selected for a prospective study with ten years follow-up (93 917 person-years). Perceived health and individual and household characteristics were measured at baseline with the Permanent Quality of Life Survey (POLS) during 1999–2002. Statistics Netherlands ascertained employment status monthly from January 1999 to December 2008. Cox proportional hazards analyses were used to determine the factors that predicted labor force exit and return to work. Results: Ill health increased the likelihood of labor force exit into unemployment [hazard ratio (HR) 1.89], disability pension (HR 6.39), and early retirement (HR 1.20), but was not a determinant of becoming economically inactive (HR 1.07). Workers with low socioeconomic status were, even after adjusting for ill health, more likely to leave the labor force due to unemployment, disability pension, and economic inactivity. Workers with ill health at baseline were less likely to return to work after unemployment (HR 0.75) or disability pension (HR 0.62). Socioeconomic status did not influence re-employment. Conclusions: Ill health is an important determinant for entering and maintaining paid employment. Workers with lower education were at increased risk for health-based selection out of paid employment. Policies to improve labor force participation, especially among low socioeconomic level workers, should protect workers with health problems against exclusion from the labor force.
http://www.sjweh.fi/show_abstract.php?abstract_id=3321

Source :  Schuring M, Robroek SJW, Otten Ferdy WJ, Arts CH, Burdorf A. The effect of ill health and socioeconomic status on labor force exit and re-employment: a prospective study with ten years follow-up in the Netherlands. Scand J Work Environ Health. http://dx.doi.org/10.5271/sjweh.3321

Economic evaluation of a participatory return-to-work intervention for temporary agency and unemployed workers sick-listed due to musculoskeletal disorders

Objectives: The aim of the study was to evaluate the cost-effectiveness, -utility, and -benefit of a newly developed participatory return-to-work (RTW) program for temporary agency and unemployed workers, sick-listed due to musculoskeletal disorders. Methods: An economic evaluation was conducted alongside a randomized controlled trial with a 12-month follow-up. Temporary agency and unemployed workers, sick-listed for 2-8 weeks due to musculoskeletal disorders, were randomized to the participatory RTW program (N=79) or usual care group (N=84). The new RTW program was aimed at making a consensus-based RTW action plan with the possibility of a temporary (therapeutic) workplace. Effect outcomes were sustainable RTW and quality-adjusted life years (QALY). Healthcare utilization was measured from the social insurer's perspective and societal perspective. Results: Total healthcare costs in the participatory RTW program group [10 189 (standard deviation [SD] 7055) euros] were statistically significantly higher compared to care-as-usual [7862 (SD 7394) euros]. The cost-effectiveness analyses showed that the new intervention was more effective but also more costly than usual care (ie, to gain RTW one day earlier in the participatory RTW program group approximately 80 euros needed to be invested). The net societal benefit of the participatory RTW program compared to care-as-usual was 2073 euros per worker. Conclusions: The newly developed participatory RTW program was more effective but also more costly than usual care. The program enhanced work resumption and generated a net socioeconomic benefit. Hence, implementation of the participatory RTW program may have potential to achieve a sustainable contribution of vulnerable workers to the labor force.

Source : Vermeulen SJ, Heymans MW, Anema JR, Schellart AJM, van Mechelen W, van der Beek AJ. Economic evaluation of a participatory return-to-work intervention for temporary agency and unemployed workers sick-listed due to musculoskeletal disorders. Scand J Work Environ Health Online-first –article
http://www.dx.doi.org/10.5271/sjweh.3314

The Danish national return-to-work program: aims, content, and design of the process and effect evaluation

The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management procedures, and (iii) a comprehensive training course for the RTW teams. The effect evaluation is based on a parallel group randomized trial and a stratified cluster controlled trial and focuses on register-based primary outcomes - duration of sickness absence and RTW - and questionnaire-based secondary outcomes such as health and workability. The process evaluation utilizes questionnaires, interviews, and municipal data. The effect evaluation tests whether participants in the intervention have a (i) shorter duration of full-time sickness absence, (ii) longer time until recurrent long-term sickness absence, (iii) faster full RTW, (iv) more positive development in health, workability, pain, and sleep; it also tests whether the program is cost-effective. The process evaluation investigates: (i) whether the expected target population is reached; (ii) if the program is implemented as intended; (iii) how the beneficiaries, the RTW teams, and the external stakeholders experience the program; and (iv) whether contextual factors influenced the implementation. The program has the potential to contribute markedly to lowering human and economic costs and increasing labor force supply. First results will be available in 2013."  

Source : Aust B, Helverskov T, Nielsen MBD, Bjorner JB et al. Scandinavian Journal of Work, Environment and Health, vol. 38, no 2, 2012,p. 120-133. http://dx.doi.org/10.5271/sjweh.3272 

Factors that Predict Return-to-work in Workers with PTSD

A considerable number of workers who suffer from work-related posttraumatic stress disorder (PTSD) are unable to return to work. The purpose of this study was to identify factors that impede return-to-work in workers suffering from PTSD. WorkSafeBC Vocational Rehabilitation Consultants and workers on medical leave due to work-related PTSD were surveyed. Factors identified by participants as barriers to return-to-work included: PTSD symptom severity, co-morbid conditions, negative beliefs about PTSD, and an overestimation of the likelihood that traumatic events would re-occur.

Source :
http://www.worksafebc.com/contact_us/research/research_results/res_60_10_1100.asp
http://www.worksafebc.com/contact_us/research/funding_decisions/assets/pdf/2007/RS2007_IG25.pdf

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