Effectiveness of the Coordinated Return to Work model after orthopaedic surgery for lumbar discectomy and hip and knee arthroplasty : a register-based study
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVES: This study examined the effectiveness of an individualised Coordinated Return to Work (CRtW) model on the length of the return to work (RTW) period compared with a standard prescription of 2-3 months RTW during recovery after lumbar discectomy and hip and knee arthroplasty among Finnish working-age population.
METHODS: Cohorts on patients aged 18-65 years old with lumbar discectomy or hip or knee arthroplasty were extracted from the electronic health records of eight Finnish hospital districts in 2015-2021 and compiled with retirement and sickness benefits. The overall effect of the CRtW model on the average RTW period was calculated as a weighted average of area-specific mean differences in RTW periods between 1 year before and 1 year after the implementation. Longer-term effects of the model were examined with an interrupted time series design estimated with a segmented regression model.
RESULTS: During the first year of the CRtW model, the average RTW period shortened by 9.1 days (95% CI 4.1 to 14.1) for hip arthroplasty and 14.4 days (95% CI 7.5 to 21.3) for knee arthroplasty. The observed differences were sustained over longer follow-up times. For lumbar discectomy, the first-year decrease was not statistically significant, but the average RTW had shortened by 36.2 days (95% CI 33.8 to 38.5) after 4.5 years.
CONCLUSIONS: The CRtW model shortened average RTW periods among working-age people during the recovery period. Further research with larger samples and longer follow-up times is needed to ensure the effectiveness of the model as a part of the Finnish healthcare system.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:81 |
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| Enthalten in: |
Occupational and environmental medicine - 81(2024), 3 vom: 08. März, Seite 150-157 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lavikainen, Piia [VerfasserIn] |
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| Links: |
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| Themen: |
Interrupted Time Series Analysis |
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| Anmerkungen: |
Date Completed 14.03.2024 Date Revised 24.03.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/oemed-2023-109276 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM368210588 |
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| 245 | 1 | 0 | |a Effectiveness of the Coordinated Return to Work model after orthopaedic surgery for lumbar discectomy and hip and knee arthroplasty |b a register-based study |
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| 520 | |a © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVES: This study examined the effectiveness of an individualised Coordinated Return to Work (CRtW) model on the length of the return to work (RTW) period compared with a standard prescription of 2-3 months RTW during recovery after lumbar discectomy and hip and knee arthroplasty among Finnish working-age population | ||
| 520 | |a METHODS: Cohorts on patients aged 18-65 years old with lumbar discectomy or hip or knee arthroplasty were extracted from the electronic health records of eight Finnish hospital districts in 2015-2021 and compiled with retirement and sickness benefits. The overall effect of the CRtW model on the average RTW period was calculated as a weighted average of area-specific mean differences in RTW periods between 1 year before and 1 year after the implementation. Longer-term effects of the model were examined with an interrupted time series design estimated with a segmented regression model | ||
| 520 | |a RESULTS: During the first year of the CRtW model, the average RTW period shortened by 9.1 days (95% CI 4.1 to 14.1) for hip arthroplasty and 14.4 days (95% CI 7.5 to 21.3) for knee arthroplasty. The observed differences were sustained over longer follow-up times. For lumbar discectomy, the first-year decrease was not statistically significant, but the average RTW had shortened by 36.2 days (95% CI 33.8 to 38.5) after 4.5 years | ||
| 520 | |a CONCLUSIONS: The CRtW model shortened average RTW periods among working-age people during the recovery period. Further research with larger samples and longer follow-up times is needed to ensure the effectiveness of the model as a part of the Finnish healthcare system | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Interrupted Time Series Analysis | |
| 650 | 4 | |a Occupational Health Services | |
| 650 | 4 | |a Rehabilitation | |
| 700 | 1 | |a Heiskanen, Jari |e verfasserin |4 aut | |
| 700 | 1 | |a Jalkanen, Kari |e verfasserin |4 aut | |
| 700 | 1 | |a Lehtimäki, Aku-Ville |e verfasserin |4 aut | |
| 700 | 1 | |a Vehkala, Saara |e verfasserin |4 aut | |
| 700 | 1 | |a Kangas, Pauliina |e verfasserin |4 aut | |
| 700 | 1 | |a Husman, Kaj |e verfasserin |4 aut | |
| 700 | 1 | |a Vohlonen, Ilkka |e verfasserin |4 aut | |
| 700 | 1 | |a Martikainen, Janne |e verfasserin |4 aut | |
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