'Return to Work' Coordinator Model and Work Participation of Employees: A Natural Intervention Study in Finland.
Johanna Kausto, Tuula Oksanen, Aki Koskinen and 7 others
PMID 33829365WHAT IT FOUND
Municipalities using return-to-work coordinators saw higher sickness absence rates but lower disability retirement risks than those without.
The coordinators appeared to keep people in the workforce with temporary leave rather than allowing permanent exits.
Key findings
01Employees in municipalities with return-to-work coordinators had a significantly higher risk of sickness absence after implementation compared to controls.
02The risk of permanent disability retirement was significantly lower in municipalities with return-to-work coordinators compared to those without.
03Among employees with reduced work ability, sickness absence trends did not differ significantly between groups, but disability retirement risk remained lower in the intervention group.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study lacked specific diagnostic data for sickness absences, so it could not distinguish between musculoskeletal and mental health causes. Musculoskeletal disorders other than rheumatoid arthritis were not included in the definition of reduced work ability, potentially affecting results for common physical conditions. The RTW-coordinator model was not standardized across municipalities, meaning the intervention varied in practice. One case municipality was excluded because it did not meet the statistical assumption of parallel pre-intervention trends.
Declared interests
Funded by the Occupational Safety Fund, Academy of Finland, and NordForsk. No other conflicts of interest declared.
The easy way to misread this
Do not interpret the higher sickness absence rates as a failure of the RTW-coordinator model. The data indicates that the model helped keep employees in the workforce (reducing permanent disability retirement), which plausibly resulted in more temporary absences rather than permanent exits.