Economic Evaluation of a Multi-Stage Return to Work Program for Workers on Sick-Leave Due to Low Back Pain

Steenstra, Ivan A., Anema, Johannes R., van Tulder , Maurits W., Bongers, Paulien, de Vet, Henrica C. W. and van Mechelen, Willem (2006) Economic Evaluation of a Multi-Stage Return to Work Program for Workers on Sick-Leave Due to Low Back Pain. Journal of Occupational Rehabilitation, 16 4: 557-578. doi:10.1007/s10926-006-9053-0


Author Steenstra, Ivan A.
Anema, Johannes R.
van Tulder , Maurits W.
Bongers, Paulien
de Vet, Henrica C. W.
van Mechelen, Willem
Title Economic Evaluation of a Multi-Stage Return to Work Program for Workers on Sick-Leave Due to Low Back Pain
Journal name Journal of Occupational Rehabilitation   Check publisher's open access policy
ISSN 1053-0487
Publication date 2006-12
Sub-type Article (original research)
DOI 10.1007/s10926-006-9053-0
Volume 16
Issue 4
Start page 557
End page 578
Total pages 22
Place of publication New York
Publisher Plenum Press
Language eng
Subject 1117 Public Health and Health Services
Formatted abstract
Objective: To evaluate the cost-effectiveness and cost-utility of a return to work (RTW) program for workers on sick-leave due to low back pain (LBP), comparing a workplace intervention implemented between 2 to 8 weeks of sick-leave with usual care, and a clinical intervention after 8 weeks of sick-leave with usual care.

Design: Economic evaluation alongside a randomised controlled trial (RCT).

Study population: Workers sick-listed for a period of 2 to 6 weeks due to LBP.

Interventions: 1. workplace assessment, work modifications and case management). 2. physiotherapy based on operant behavioural principles. 3. usual care: provided by an occupational physician.

Outcomes: The primary outcome was return to work (RTW). Other outcomes were pain intensity, functional status, quality of life and general health. The economic evaluation was conducted from a societal perspective. Outcomes were assessed at baseline (after 2–6 weeks on sick-leave), and 12 weeks, 26 weeks, and 52 weeks after the first day of sick-leave.

Results: The workplace intervention group returned to work 30.0 days (95% CI=[3.1, 51.3]) earlier on average than the usual care group at slightly higher direct costs (ratio of 1 day: €19). Workers in the clinical intervention group that had received usual care in the first 8 weeks returned to work 21.3 days (95% CI= [−74.1, 29.2]) later on average. The group that had received the workplace intervention in the first 8 weeks and the clinical intervention after 8 weeks returned to work 50.9 days (95% CI=[−89.4, −2.7]) later on average. A workplace intervention was more effective than usual care in RTW at slightly higher costs and was equally effective as usual care at equal costs on other outcomes. A clinical intervention was less effective than usual care and associated with higher costs.

Conclusion: The workplace intervention results in a safe and faster RTW than usual care at reasonable costs for workers on sick-leave for two to six weeks due to LBP.
Keyword Low back pain
Operant behavioural
Participative Ergonomics
Return to work
Randomized Controlled Trial
Cost-effectiveness
Occupational health
References - - - - - -
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Human Movement and Nutrition Sciences Publications
 
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Created: Mon, 06 Apr 2009, 09:56:10 EST by Maryanne Watson on behalf of School of Human Movement and Nutrition Sciences