Effect of the Danish return-to-work program on long-term sickness absence: results from a randomized controlled trial in three municipalities

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Otto M Poulsen, Birgit Aust, Jakob Bjørner, Reiner Rugulies, Jørgen V Hansen, Torill Tverborgvik, Glen Winzor, Ole S Mortensen, Trine Helverskov, Palle Orbæk, Maj-Britt Nielsen

OBJECTIVES: The aim of this study was to evaluate the effect of the Danish return-to-work (RTW) program on long-term sickness absence in a randomized controlled trial in three municipalities.

METHODS: The intervention group comprised 1948 participants while the control group comprised 1157 participant receiving ordinary sickness benefit management (OSM). Study participants were working-age adults receiving long-term (≥8 weeks or more) benefits, included regardless of reason for sickness absence or employment status. Each beneficiary was followed-up for a maximum period of 52 weeks. Cox proportional hazards model was used to estimate hazard ratios (HR) for return to work (RTW) with 95% confidence intervals (95% CI).

RESULTS: The intervention effect differed significantly between the municipalities (P=0.00005). In one municipality (M2) the intervention resulted in a statistically significant increased rate of recovery from long-term sickness absence (HR 1.51, 95% CI 1.31-1.74). In the other two municipalities, the intervention did not show a statistically significant effect (HR M11.12, 95% CI 0.97-1.29, and HR M30.80, 95% CI 0.63-1.03, respectively). Adjustment for a series of possible confounders only marginally altered the estimated HR.

CONCLUSION: The effect of the intervention differed substantially between the three municipalities, indicating that that contextual factors are of major importance for success or failure of this complex intervention.

Original languageEnglish
JournalScandinavian Journal of Work, Environment & Health
Volume40
Issue number1
Pages (from-to)47-56
Number of pages10
ISSN0355-3140
DOIs
Publication statusPublished - Jan 2014

    Research areas

  • Adolescent, Adult, Denmark, Humans, Middle Aged, Return to Work, Sick Leave, Young Adult

ID: 136794263