Etelä-Savo, Pihlajalinna Oyj, Mikkeli, Finland
Conmedic Ltd, Espoo, Finland.
Occup Environ Med. 2023 Mar;80(3):170-176. doi: 10.1136/oemed-2022-108613. Epub 2023 Jan 25.
Work disability management is a problem globally. This study was designed to find out whether the initiation, process and outcome of health check-ups (HCUs) follow the national legislation and whether supervisors and occupational healthcare (OHC) units act according to the legislation-based recommendations.
Data of 1092 employees with reduced work ability were collected during 2013-2018 in 15 OHC units across Finland. Nine reasons for HCUs, eight process activities and three recommendations were analysed. Cross-tabulation and multinomial logistic regression analysis were used in the analyses.
Employees themselves initiated an HCU for early support more often (OR with 95% CI 2.37; 1.04 to 5.40) compared with supervisors. Personnel in OHC units initiated an HCU in musculoskeletal disorders more often (OR 1.58; 95% CI 1.05 to 2.37) and in mental disorders less often (OR 0.52; 95% CI 0.35 to 0.76) compared with supervisors. These findings were reflected in the recommendations after the HCU, where rehabilitation was recommended for employees with musculoskeletal disorders more often than for employees with mental disorders (ORs 5.48; 95% CI 1.91 to 15.67 and 1.59; 95% CI 0.74 to 3.43, respectively).
Supervisors and OHC units followed the recommendations for management of work disability to a great extent. Employees were active in looking for help early when they had problems with work ability. This positive finding should be promoted even more. OHC units did not initiate HCUs or recommend rehabilitation in mental disorders as actively as they did in musculoskeletal disorders. Support of employees with mental disorders should be improved and studied more. The study protocol was approved and registered on 22 September 2017 by the Doctoral Program of Health Sciences, Faculty of Medicine, University of Eastern Finland, registration no. 189067.
工作残疾管理是一个全球性问题。本研究旨在了解健康检查(HCUs)的启动、过程和结果是否符合国家立法,以及主管和职业保健(OHC)单位是否按照基于立法的建议行事。
在芬兰 15 个 OHC 单位,于 2013 年至 2018 年期间收集了 1092 名工作能力下降的员工的数据。分析了 9 个 HCU 原因、8 个过程活动和 3 个建议。在分析中使用了交叉表和多项逻辑回归分析。
与主管相比,员工自己更多地发起 HCU 以获得早期支持(OR 95%CI 2.37;1.04 至 5.40)。OHC 单位的人员更频繁地发起肌肉骨骼疾病的 HCU(OR 1.58;95%CI 1.05 至 2.37)和较少发起精神障碍的 HCU(OR 0.52;95%CI 0.35 至 0.76)与主管相比。这些发现反映在 HCU 后的建议中,肌肉骨骼疾病的员工比精神障碍的员工更常被推荐康复(ORs 5.48;95%CI 1.91 至 15.67 和 1.59;95%CI 0.74 至 3.43)。
主管和 OHC 单位在很大程度上遵循了工作残疾管理的建议。当员工工作能力出现问题时,他们积极寻求早期帮助。这一积极发现应得到进一步推广。OHC 单位没有像处理肌肉骨骼疾病那样积极地发起 HCU 或建议康复治疗精神障碍。应改善和更多地研究对精神障碍员工的支持。该研究方案于 2017 年 9 月 22 日由东芬兰大学医学系健康科学博士课程批准并注册,注册号为 189067。