National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100 Copenhagen, Denmark.
Scand J Work Environ Health. 2015 Nov;41(6):529-41. doi: 10.5271/sjweh.3528. Epub 2015 Oct 7.
The aim of this study was to evaluate the implementation of the Danish national return-to-work (RTW) program in 21 Danish municipalities.
We conducted a structured process evaluation on (i) reach and recruitment, (ii) fidelity, (iii) dose-delivered, (iv) dose-received, and (v) context by formulating 29 implementation criteria and analyzing qualitative and quantitative data from administrative records, interviews, field notes, and questionnaires.
All municipalities integrated the basic features of the RTW program into the existing framework of the sickness benefit management system to an acceptable degree, ie, establishment of RTW teams, participation of RTW team members in the training courses, and following the general procedures of the program. However, the level of implementation varied considerably between the municipalities, particularly with respect to fidelity (defined as implementation consistent with the principles of the interdisciplinary RTW process). Five municipalities had high and eight had low fidelity scores. Similar large differences were found with regard to dose-delivered, particularly in the quality of cooperation with beneficiaries, employers, and general practitioners. Only 50% of the first consultations with the RTW coordinator were conducted in time. Among participants who were employed when their sickness absence period started, only 9% had at least one meeting with their workplace.
It was feasible to implement the basic features of the Danish RTW program, however, large variations existed between municipalities. Establishment of well-functioning interdisciplinary RTW teams might require more time and resources, while ensuring early assessment and more frequent cooperation with employers might need more general adjustments in the Danish sickness benefit system.
本研究旨在评估丹麦 21 个市实施丹麦国家重返工作岗位（RTW）计划的情况。
我们通过制定 29 项实施标准，并对来自行政记录、访谈、现场记录和问卷调查的定性和定量数据进行分析，对（i）覆盖范围和招募、（ii）保真度、（iii）剂量传递、（iv）剂量接收和（v）背景进行了结构化的过程评估。
所有市都将 RTW 计划的基本特征以可接受的程度整合到病假津贴管理系统的现有框架中，即建立 RTW 团队、RTW 团队成员参加培训课程以及遵循该计划的一般程序。然而，各市之间的实施水平差异很大，特别是在保真度方面（定义为与跨学科 RTW 过程原则一致的实施）。五个市的保真度得分较高，八个市的得分较低。在剂量传递方面，特别是在与受益人、雇主和全科医生合作的质量方面，也发现了类似的较大差异。只有 50%的 RTW 协调员的首次咨询是及时进行的。在病假开始时就业的参与者中，只有 9%的人至少与工作场所进行了一次会议。
实施丹麦 RTW 计划的基本特征是可行的，但各市之间存在较大差异。建立运作良好的跨学科 RTW 团队可能需要更多的时间和资源，而确保早期评估和更频繁地与雇主合作可能需要对丹麦病假津贴制度进行更多的一般性调整。
