Selection of clients for vocational rehabilitation at six local social insurance offices: A combined register and questionnaire study on rehabilitation measures and attitudes among social insurance officers

Ahlgren, Åsa; Bergroth, Alf; Ekholm, Jan; Ekholm, Kristina Schüldt

doi:10.2340/16501977-0157

Cited by 5 publications

(14 citation statements)

References 22 publications

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“…For review question 1 on the access to vocational rehabilitation, six observational studies [12,[19][20][21][22][23] of populationbased or employee-based registers of people on sick leave in Sweden were included, in which their receipt of vocational rehabilitation was recorded and analysed by socio-economic, demographic or health characteristics of individuals. One study included a questionnaire survey [12], which examined informants' knowledge of bias in attitudes and practices regarding selection for VR under the Swedish national framework legislation.…”

Section: Resultsmentioning

confidence: 99%

“…This allows considerable differences in the choice of rehabilitation measure in different offices and in treatment and/or options offered to a person on sick leave [12,17].…”

Section: The National Policy Contextmentioning

confidence: 99%

“…A related study in 1998-1999 focused on the differences between the six local social insurance offices in the same county with regard to their selection of clients for vocational rehabilitation [12]. Thirty local social insurance officers responded to a survey questionnaire about their attitudes and practices regarding rehabilitation.…”

Section: Is There Differential Access To Rehabilitation?mentioning

confidence: 99%

“…Against this background, increased emphasis has been placed on vocational rehabilitation as a means of returning people to work. National social insurance legislation provides for equal access to vocational rehabilitation measures [11,12]: all working-age individuals in Sweden (with a few exceptions) when on long-term sick leave have the possibility (but not the right) to receive vocational rehabilitation.…”

Section: The National Policy Contextmentioning

confidence: 99%

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How equitable is vocational rehabilitation in Sweden? A review of evidence on the implementation of a national policy framework

Burström

Nylén

Clayton

et al. 2010

Disability and Rehabilitation

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Purpose. Under the national framework law in Sweden, all eligible people should have equal chances of receiving vocational rehabilitation. We aimed to review the evidence on (1) whether access to vocational rehabilitation is equitable in practice and (2) whether the outcomes vary for different groups in the population. Method. Systematic review of studies in Sweden that reported diagnostic or socio-demographic characteristics of people offered or taking up rehabilitation programmes and outcomes of such programmes for different diagnostic and sociodemographic groups. Searches of 11 relevant electronic databases, 15 organisational websites, citation searching and contact with experts in the field, for the period 1990-2009. Results. A total of 11 studies were included in the final review, six of which addressed review question (1) and seven addressed review question (2). All the six observational studies of access reported biased selection into vocational rehabilitation: greater likelihood for men, younger people, those with longer-term sick leave, those with lower income, employed rather than unemployed people and those with musculoskeletal and mental disorders or alcohol abuse. Having had a rehabilitation investigation also increased the likelihood of receiving vocational rehabilitation. Differential outcome of rehabilitation was reported in seven studies: outcomes were better for men, younger people, employed individuals, those with shorter sick leave and those with higher income. Selection into vocational rehabilitation was perceived as important for successful outcomes, but success also depended on the state of the local labour market. Conclusions. There is evidence of socio-demographic differences in access to and outcomes of vocational rehabilitation in Sweden, even though the national framework law is meant to apply to everyone. Few studies have deliberately measured differential access or outcomes, and there is a need for this kind of equity analysis of population-wide policies. Studies evaluating the effects of vocational rehabilitation must consider selection into the programmes for adequate interpretation of impact results.

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Section: Resultsmentioning

confidence: 99%

“…This allows considerable differences in the choice of rehabilitation measure in different offices and in treatment and/or options offered to a person on sick leave [12,17].…”

Section: The National Policy Contextmentioning

confidence: 99%

Section: Is There Differential Access To Rehabilitation?mentioning

confidence: 99%

Section: The National Policy Contextmentioning

confidence: 99%

See 2 more Smart Citations

How equitable is vocational rehabilitation in Sweden? A review of evidence on the implementation of a national policy framework

Burström

Nylén

Clayton

et al. 2010

Disability and Rehabilitation

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show abstract

“…Employment counselors pointed out the importance of a close interpersonal client-VRP relationship in the RTW process (18). Social insurance officers mentioned that the employer's attitude to the employee is an essential factor for successful vocational rehabilitation (40). Employees on sick leave mentioned that taking the client seriously promotes RTW (7).…”

Section: Interpreting Our Findingsmentioning

confidence: 99%

What promotes sustained return to work of employees on long-term sick leave? Perspectives of vocational rehabilitation professionals

Dekkers-Sánchez

Wind

Sluiter

et al. 2011

Scand J Work Environ Health

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Objectives The aim of this study was to (i) explore promoting factors for sustained return to work (RTW), according to vocational rehabilitation professionals (VRP) that are amenable to change for employees who have been on sick leave >18 months and (ii) gain insight into crucial aspects of interventions.Methods Semi-structured interviews were carried out with 23 VRP. All interviews were transcribed fullyverbatim. An inductive analysis of the transcripts was performed, using a process of identifying, coding, and categorizing the primary patterns in the data.Results Key influenceable promoting factors for sustained RTW by long-term sick-listed employees include:employee-based vocational guidance; integral, effective communication between the sick-listed employee and all RTW stakeholders; personal factors; a supportive work environment; and a stimulating social environment. Crucial aspects of interventions include: gathering information and setting priorities; improving qualifications; influencing cognitions; monitoring the sick-listed employee through the rehabilitation process; offering tailormade interventions at different stages within a personal time-bound action plan; and preparing the employee and the work environment for RTW.Conclusions Sustained RTW for long-term sick-listed employees can be achieved by focusing on the influenceable promoting factors for RTW. The use of combined interventions in a holistic approach involving the worker and his environment is considered the best way to address the multicausality of work disability and could help maximize RTW outcomes.Key terms long-term sickness absence; return-to-work facilitators; RTW; RTW coordinators; sickness absence; work disablement; work rehabilitation. [E-mail: p.m.dekkers@amc.uva.nl] Long-term sick leave is a major socioeconomic problem in Western countries due to the enormous financial costs for society (1). Several studies have shown the importance of the return-to-work (RTW) transition process for employees on long-term sick leave (2-4). Early research has shown that the probability of RTW decreases as the duration of sick leave lengthens (5). Achieving early job reintegration of chronic work-disabled employees is a difficult goal to accomplish due to the complexity of factors involved, and the issue needs ongoing attention.An employee on long-term sick leave is an individual who functions in a complex context in which different factors can play a role, such as medical, personal, environmental, or work-related factors (6). These factors can either perpetuate sick leave or promote RTW (7) among employees who have been sick-listed for >1.5 years; the factors that stimulate RTW may be different from those that facilitate a sustained RTW. Some promoting factors for RTW are potentially influenceable and could offer opportunities for health professionals to improve work participation. Therefore, stimulation of these positive factors is important to facilitate work resumption of employees on long-term sick leave.There are several important actors...

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Individual- and Company-Level Predictors of Receiving Vocational Rehabilitation: A Multilevel Study of Finnish Private Sector Workplaces

et al. 2019

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Selection of clients for vocational rehabilitation at six local social insurance offices: A combined register and questionnaire study on rehabilitation measures and attitudes among social insurance officers

Cited by 5 publications

References 22 publications

How equitable is vocational rehabilitation in Sweden? A review of evidence on the implementation of a national policy framework

How equitable is vocational rehabilitation in Sweden? A review of evidence on the implementation of a national policy framework

What promotes sustained return to work of employees on long-term sick leave? Perspectives of vocational rehabilitation professionals

Individual- and Company-Level Predictors of Receiving Vocational Rehabilitation: A Multilevel Study of Finnish Private Sector Workplaces

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