Table 2. Characteristics of interventions and comparisons.
Study: intervention title | Provider(s) of RTW-coordination: | Affiliation of RTW-coordinator(s) | Process of RTW-coordination | Duration | Consumption of health care and other services | Adherence of RTW-coordinators and participants | Usual practice |
Bültmannn 2009: “Coordinated and Tailored Work rehabilitation” | 1 rehab. team: OP, occupational PT, chiropractor, psychologist, social worker, experience and training n.r. | N.r. | Standardised assessment of disability and functioning, identification of barriers for RTW; individually tailored RTW-plan, actions directed at worker, workplace, and environment. Social worker coordinates with workplace and municipality case manager | Maximal 3 month | Increase | all patients received RTW-plan | Optional case management from municipal case managers |
Davey 1994: “Rehabilitation co-ordinator service” | 1 coordinator: PT, experience in care coordination, no specific training | Academic rehab. unit | Assessment at the participant's home, RTW-plan with focus on involving each claimant to the fullest possible extent, coordinator discussed plan with a psychologist and a physician, monitoring, making changes as appropriate | 6 month | Increase | N.r. | No restriction |
Donceel 1999: “New guideline for medical advisers” | 30 medical advisers: social insurance physicians, experience and training n.r. | One private insurer | Monthly follow-up: Clinical and functional assessment, exploration of barriers for RTW, advice on legal criteria, gradual RTW, exercise, and normal course of work incapacity, encouragement of rehab., communication with treating physicians; case discussion with colleagues; referral to rehab. if no RTW after 3-4 months3 | As long as participant on disability benefit | N.r. | no drop-outs3 | 30 medical advisors, focus on corporal damage, little rehab. efforts |
Feuerstein 2003: “Integrated case management” | 32 nurse case managers: 2 day training in ergonomic assessment and workplace accommodations, problem solving approach, experience in coordination of medical care | US Department of Labour | Semi structured interview, ergonomic worksite assessment, case management plan with workplace accommodation, applying problem solving process, monitoring, coordination of medical care (detailed list of workplace accommodations reported2) | 4 month, variable | N.r. | N.r. | 33 Nurse case managers, focus on medical care, no training in a structured protocol |
Lambeek 2010: “Integrated care” | 2 case managers: OPs, 2-day training program | University hospital | Individualised RTW-plan, coordination of care, communication with occupational therapists (mandatory workplace intervention based on participatory ergonomics) and physical therapists (mandatory graded activity program using cognitive behavioural principles). Conference calls every three weeks, strict timing. | 67 (SD 32) calendar days | Decrease | N.r. | Guidance from OPs, GPs and other health professionals. averagely 0.2 visits to case managers |
Lindh 1998: “Multidisciplinary rehabilitation programme” | 1 rehab. team: rehab. physician, nurse, physical therapist, psychotherapist, psychologist, occupational therapist, social worker, vocational counsellor, experience and training n.r. | Outpatient rehab. clinic | Medical, functional, psychological and social assessment, RTW-plan, weekly team conferences, regular meetings with participant and spouse | Individually regulated | N.r. | N.r. | Physical therapy and other rehab. measures |
Purdon 20061: “Job Retention and Rehabilitation” | Case managers, experience and training n.r. | 4 third-party case management providers | Point of contact for clients, giving advice, gate keeping to other services, sometimes providing services, coordination of medical care, rehab., employer, ergonomic workplace assessment, occupational therapy, advising on welfare rights, career, CV preparation, and job search. | 20 to 36 weeks | No change | 88% received RTW-plan, 72% of those followed the plan | No systematic aid; low levels of work support |
Rossignol 2000: “Program for coordination of primary health care “ | 1 team: 2 primary care physicians, 1 nurse, experience and training n.r. | N.r. | Standardised medical assessment, RTW-plan according to clinical guideline for back pain. Assisting the treating physicians in finding and scheduling diagnostic and therapeutic procedures, cooperation with Worker's Compensation, standardised weekly telephone talk | Until RTW | No change | N.r. | Instruction to continue with treating physician |
Van der Feltz-Cornelis 2010: “psychiatric consultation model” | 12 OPs, training in diagnosis and treatment of mental disorders. consulted by 2 psychiatrist trained in improvement of work functioning | Company of participant | Psychiatric assessment, collaborative RTW-plan, coordination of plan and monitoring by OP | Until RTW | N.r. | N.r. | Care from OP2 and mental health care professionals |
RTW = return to work, n.r. = not reported, OP = occupational physician, PT = physical therapist, GP = general practitioner, rehab. = rehabilitation.
The trial compared three intervention arms with usual practice. We considered only the arm “combined intervention” because the other arms were restricted to either workplace or health care interventions.
In the Dutch system, each company is obliged to have company insurance for sick leave and to offer their employees access to occupational health care. Occupational physicians provide social-medical guidance for sick listed employees with the aim to return to work (RTW) as quickly as possible. Usually, occupational physicians are organised as third party service providers.
From personal correspondence.