Objectives: The aim of this study was to evaluate the effect of the Danish return-to-work (RTW) program on long-term sickness absence in a randomized controlled trial in three municipalities. Methods: The intervention group comprised 1948 participants while the control group comprised 1157 participant receiving ordinary sickness benefit management (OSM). Study participants were working-age adults receiving long-term (≥8 weeks or more) benefits, included regardless of reason for sickness absence or employment status. Each beneficiary was followed-up for a maximum period of 52 weeks. Cox proportional hazards model was used to estimate hazard ratios (HR) for return to work (RTW) with 95% confidence intervals (95% CI). Results: The intervention effect differed significantly between the municipalities (P=0.00005). In one municipality (M2) the intervention resulted in a statistically significant increased rate of recovery from long-term sickness absence (HR 1.51, 95% CI 1.31–1.74). In the other two municipalities, the intervention did not show a statistically significant effect (HRM1 1.12, 95% CI 0.97–1.29, and HRM3 0.80, 95% CI 0.63–1.03, respectively). Adjustment for a series of possible confounders only marginally altered the estimated HR. Conclusion: The effect of the intervention differed substantially between the three municipalities, indicating that that contextual factors are of major importance for success...

Poulsen, Otto M; Aust, Birgit; Bjorner, Jakob Bue; Rugulies, Reiner; Hansen, Jørgen V.; Tverborgvik, Torill; Winzor, Glen; Mortensen, Ole S.; Helerskov, Trine; Ørbæk, Palle; Nielsen, Maj Britt
Scandinavian Journal of Work, Environment and Health 40(1): 47–56
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