Affiliations: Department of Social Medicine, The Sahlgrenska Academy
at Göteborg University, Sweden | Head of Department of Social Medicine and
Epidemiology, Stockholm County Council, Stockholm, Sweden
Note: [] Address for correspondence: Eva-Lisa Hultberg, Department of
Social Medicine, The Sahlgrenska Academy at Göteborg University, Box 453,
SE-405 30 Göteborg, Sweden. Tel.: +46 31 773 6863/+46 709 560933; Fax: +46
31 162847; E-mail: eva-lisa.hultberg@socmed.gu.se
Abstract: Aims: The aim of the study was to assess if health care centres with
a co-financing model for collaborative rehabilitation between primary health
care, sickness insurance offices and social welfare offices reduced sick leave
among persons with musculoskeletal disorders compared to health centres with
conventional rehabilitation structures. Method: A comparative prospective study was conducted.
Consecutive patients aged 16–64 with musculoskeletal disorders attending the
health care centres with (n=107) and without (n=31) co-financing model were
interviewed. In addition, we collected register data about patients' allowances
for sick leave days for totally 18 months. Results: The intervention group had an average of 94 days and
the controls 87 days on sick leave during the 12-months period after inclusion
in the study. At 12 months the proportion of patients sick listed was 31% in
the intervention group and 32% in the control group. Conclusion: The study could not show that the co-financing
model reduced the numbers of sick leave days among patients with
musculoskeletal disorders. A possible explanation for the lack of positive
impact on patients' health or work ability might be that the working procedure
has in fact not really been changed and the tool mix lack solid evidence. The
study identifies some methodological problems addressed in future research
trying to link organisational changes with patient outcomes.
