Department of Medical and Health Sciences, National Centre for Work and Rehabilitation, Linköping University, Linköping, Sweden.
Disabil Rehabil. 2011;33(15-16):1373-82. doi: 10.3109/09638288.2010.532282. Epub 2010 Nov 17.
Changes in the Swedish sickness insurance system shifts focus from return-to-work to labour market reintegration. This article analyses Swedish rehabilitation professionals' perspectives on how the changed regulations affect practice, with a special focus on work ability assessments.
Two groups of representatives (n = 15) from organizations involved in rehabilitation and return-to-work met at seven occations. The groups worked with a tutor with a problem-based approach to discuss how their practice is influenced by the changed regulations. The material was analysed inductively using qualitative content analysis.
The new regulations require developed cooperation among insurance, health care, employers and occupational health care; however, these demands are not met in practice. In work ability assessments, several flaws regarding competence and cooperation are identified. An increasing number of people previously assessed as work disabled are required to participate in labour market reintegration, which puts demands on professionals to engage in motivational activities, although this is perceived as hopeless due to the group's lack of employability.
The possibility for employers to sidestep their responsibility has increased with changed regulations. The overall lack of cooperation between relevant actors and the lack of relevant competence undermine the ambitions of activation and reintegration in the reform.
瑞典医疗保险制度的变化将重点从重返工作岗位转移到劳动力市场重新融入。本文分析了瑞典康复专业人员对这些变化如何影响实践的看法，特别关注工作能力评估。
两组（每组 15 名）来自参与康复和重返工作的组织的代表在七个场合会面。这些小组与一名导师一起以基于问题的方法进行合作，讨论他们的实践是如何受到新法规影响的。使用定性内容分析对材料进行了归纳分析。
新法规要求保险、医疗保健、雇主和职业保健之间开展更深入的合作，但这些要求在实践中并未得到满足。在工作能力评估中，发现了一些关于能力和合作的缺陷。越来越多以前被评估为无法工作的人需要参加劳动力市场重新融入计划，这要求专业人员参与激励活动，尽管由于该群体缺乏就业能力，这被认为是无望的。
变化后的法规增加了雇主逃避责任的可能性。相关行为者之间缺乏合作以及缺乏相关能力，破坏了改革中激活和重新融入的雄心。
