Ektor-Andersen John, Ingvarsson Elisabet, Kullendorff Marianne, Orbaek Palle
Multidisciplinary Pain Clinic, Primary Care Region Skåne, Malmö, Sweden.
J Rehabil Med. 2008 Jan;40(1):1-8. doi: 10.2340/16501977-0127.
To report the results from a prospective, cognitive-behavioural team-based, individually geared, low-intensity, rehabilitation programme, randomly assigned to care-seekers in primary care physiotherapy with new pain-related sick leave, and to examine a possible reduction in social security expenditure.
A total of 194 care-seekers were included in a stepwise procedure from November 2000 to February 2002. Control group n = 381.
The median number of days of sick leave in the intervention group was 22 during the first 6-month period. After 180 days 5.2% were still on sick leave and after 360 days 4.2%. The comparable figures in the control group were 30 days, 9.7% and 7.2%, respectively. Reductions in social security expenditure were statistically significant from the fourth month. As predicted, clinically relevant subgroups contributed differently to this reduction, both early and later on. The overall problem for one-third of the subgroups was insufficient co-ordination from the employer and the social security executive.
It was possible to reduce the social security expenditure in this setting. The intervention costs were balanced out during the first year. A large potential for further cost reductions was identified in increased implementation of workplace-based return-to-work interventions.
报告一项前瞻性、基于认知行为团队、个性化、低强度的康复计划的结果，该计划被随机分配给因新的疼痛相关病假而寻求初级保健物理治疗的患者，并研究社会保障支出是否可能减少。
从2000年11月至2002年2月，共有194名寻求治疗者通过逐步程序纳入研究。对照组n = 381。
干预组在前6个月期间病假天数的中位数为22天。180天后，5.2%的人仍在病假，360天后为4.2%。对照组的相应数字分别为30天、9.7%和7.2%。从第四个月起，社会保障支出的减少具有统计学意义。正如预测的那样，临床相关亚组在早期和后期对这种减少的贡献不同。三分之一亚组的总体问题是雇主和社会保障执行机构的协调不足。
在这种情况下有可能减少社会保障支出。干预成本在第一年得到了平衡。通过更多地实施基于工作场所的重返工作干预措施，发现了进一步降低成本的巨大潜力。
