| 1. |
- Kärrholm, Johan, 1951, et al.
(författare)
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Effects on work resumption of a co-operation project in vocational rehabilitation. Systematic, multi-professional, client-centred and solution-oriented co-operation
- 2006
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Ingår i: Disabil Rehabil. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 28:7, s. 457-67
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The present aim was to evaluate the effect of systematic multi-professional co-ordinated rehabilitation (the Stockholm Co-operation Project) on the number of days' sick leave during the first and second half-years after the rehabilitation co-ordination period, compared to the year before. Another aim was to evaluate the economic effects at national level. METHOD: A matched-pairs design was used. The study group was based on 64 rehabilitees employed by a public employer in Stockholm, who took part in a systematic multi-professional co-operation project. To obtain pairs, the 64 individuals were individually matched with 64 people who received conventionally organised rehabilitation. Thus, there were 128 subjects altogether. RESULTS: The study group had substantially less sick leave days per month than the comparison group during the second half-year after the rehabilitation co-ordination period. The effect was even greater in a subgroup with more previous sick leave. During the first half-year after the intervention the comparison group had relatively more sick leave. No effect was found for a subgroup with less previous sick leave. The economic benefit of the intervention was estimated to 1,278 euros per month and person based on the whole group, and to 2,405 euros per month and person based on those with more sick leave. CONCLUSIONS: People who undergo co-ordinated rehabilitation have more working days after the intervention period than those with conventional rehabilitation. This way for rehabilitation actors to co-operate gives better outcomes for rehabilitation cases with long previous sick leave, but not for cases with less previous sick leave. It also generates economic gains at several levels.
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| 2. |
- Kärrholm, Jenny, et al.
(författare)
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Systematic co-operation between employer, occupational health service and social insurance office : A 6-year follow-up of vocational rehabilitation for people on sick-leave, including economic benefits
- 2008
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 40:8, s. 628-636
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the effects of systematic co-operation among municipal employees on the number of sick-leave days per month and the type of benefit granted by the Social Insurance Office. A further aim was to evaluate the economic consequences for society.Design: A 6-year follow-up study with a matched-pairs design.Methods: Days on sick-leave were calculated for each subject one year before the intervention started and yearly for the following 6-year period. Statistical mixed-model analysis was used. The economic benefit of the intervention was estimated as the increased production stemming from fewer days on sick-leave.Subjects: Sixty-four employees on long-term sick-leave were individually matched with controls from another Social Insurance Office in a county with a socioeconomic structure similar to that of the study group.Results: The study group had 5.7 fewer days on sick-leave per month and person over the 6-year period (p=0.003). The estimated average economic benefit of the intervention was (sic)36,600 per person over the 6-year period. In conclusion, those who received systematic co-operation in vocational rehabilitation had fewer days on sick-leave than their ""treatment-as-usual"" peers. This effect persisted over 6 years, generating substantial net economic gains for society.
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| 3. |
- Ahlgren, Åsa, et al.
(författare)
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Selection of clients for vocational rehabilitation at six local social insurance offices. : a combined register and questionnaire study on rehabilitation measures and attitudes among social insurance officers.
- 2008
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081 .- 0001-5555. ; 40:3, s. 178-184
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to evaluate possible differences between local social insurance offices with regard to their selection of clients for vocational rehabilitation. A further aim was to determine whether social insurance officers from different local insurance offices have uniform attitudes regarding professional practice in their application of the insurance system. METHODS: A register-based investigation of 815 vocational rehabilitees served by 6 local social insurance offices in a Swedish county. The study was supplemented with a questionnaire to 30 officers about attitudes to social insurance. RESULTS: The office with the lowest rate of sick-listing periods exceeding one year, and a high frequency of employment training, showed the highest degree of work resumption and the lowest pension rate after vocational rehabilitation. There were wide differences in attitude among the local social insurance officers regarding professional practice in their application of the system. CONCLUSION: Intra-county differences occur in handling people on sick-leave who undergo vocational rehabilitation. The local social insurance offices with the highest and lowest outcome rates of work resumption and disability pension, respectively, select clients for vocational rehabilitation from different categories of cases. Social insurance officers from different local offices differ in their attitudes towards the social insurance system and its clients.
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| 4. |
- Ahlgren, Åsa, et al.
(författare)
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Work resumption after vocational rehabilitation : a follow-up two years after completed rehabilitation
- 2007
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 28:4, s. 343-354
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Tidskriftsartikel (refereegranskat)abstract
- A short-term evaluation of vocational rehabilitation (VR) may give conclusions not automatically applicable over a longer term. The present study follows up alterations in work resumption or in social insurance benefits from the time of completed VR and during the following two years. AIM: The primary objective was to evaluate work resumption among previous sick-leavers granted vocational rehabilitation. The aim of the follow-up was to assess the stability of the outcome of VR over time and to analyse factors of importance for clients that remained at work. METHOD: A register investigation was based on 815 cases where the clients had taken part in vocational rehabilitation and were served by one of six local social insurance offices of a Swedish county. RESULTS: Of the clients studied, 52.4% had attained full working capacity The proportion had decreased to 37.4% two years later. One factor that differed between those who resumed work and those who returned to sick leave was the duration of the previous sick-leave period. Those who returned to work had had shorter sick leave, had jobs to return to and had received job training as a vocational rehabilitation measure. CONCLUSIONS: The clients with the best chances of being in work two years after completed vocational rehabilitation were those with short sickness absence, who had been selected for job training as a vocational rehabilitation, were aged 16-29 years and were employed in industry.
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| 5. |
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| 6. |
- Björnhagen, Viveca, et al.
(författare)
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Burn survivors' pulmonary and muscular impairment, exercise tolerance and return-to-work following medical-vocational rehabilitation : A long-term follow-up
- 2018
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 50:5, s. 465-471
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To follow up the long-term outcome in return-to-work (RTW) rate in burn-injury patients, and to determine the degree of impairment in pulmonary and muscular function and exercise tolerance. Design: A prospective, longitudinal follow-up study without a control group. Patients: Twenty-five burn-injury patients referred for medical-vocational rehabilitation. Methods: Return-to-work rate was followed after completed medical-vocational rehabilitation. Pulmonary function was evaluated with spirometry, diffusing capacity and radio spirometry. Exercise capacity was determined using a bicycle ergometer. Muscle functions evaluated in the arms and legs were: isokinetic torque, isometric strength, endurance and muscular strength utilization. Results: Return-to-work rate was 87%. During bicycle exercise tests the patients, on average, reached their expected workloads. The dominating lung function abnormality observed on lung scintigraphy was delayed wash-out time of inhaled radioactive xenon gas, suggesting airway obstruction. All tests of shoulder-flexor and knee-extensor muscle function showed large minimum-maximum differences. Mean isometric endurance of shoulder flexors was lower than mean of references, and isokinetic knee extensor torques were slightly lower. Conclusion: High return-to-work rates can be achieved after burn injury requiring hospital-ward care. Despite measurable impairments in muscle strength/endurance and pulmonary function in a substantial proportion of these patients, overall normal bicycle exercise capacity was observed except for a few cases.
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| 7. |
- Chamberlain, M A, et al.
(författare)
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Vocational rehabilitation : An educational review
- 2009
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Ingår i: Journal of rehabilitation. - : Medical Journals Sweden AB. - 0022-4154 .- 1650-1977 .- 1651-2081. ; 41:11, s. 856-869
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Forskningsöversikt (refereegranskat)abstract
- The aim of this review is to describe aspects of vocational rehabilitation relevant for a physician aiming to become a specialist in physical and rehabilitation medicine (PRM). The review discusses the epidemiology of incapacity for work, the major patient groups in vocational rehabilitation (musculoskeletal and psychiatric diagnoses comprise approximately 50-70% of the patients), the influence of different kinds of environmental and individual risk factors on work resumption (such as the legal framework, application of the law, resources for rehabilitation and its effectiveness, the degree of co-operation between vocational rehabilitation agencies, economic factors/labour market situation, medical and personal factors). The review describes different models of vocational rehabilitation, the effectiveness of various vocational rehabilitation programmes on work resumption or sick leave (where strong evidence is reported for multimodal rehabilitation programmes for patients with long-lasting musculoskeletal pain). Finally, there are sections about the PRM physician's history-taking in vocational rehabilitation (using the International Classification of Functioning, Disability and Health (ICF)), and report writing with a Structure where ICF body functions and activity limitations are reported separately.
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