期刊论文详细信息
BMC Public Health
Promoting occupational health interventions in early return to work by implementing financial subsidies: a Swedish case study
Katarina Kjellberg2  Kerstin Ekberg3  Carl Åborg2  Allan Toomingas2  Christian Ståhl1 
[1]National Centre for Work and Rehabilitation, Department of Medical and Health Sciences, Linköping University, Linköping 581 83, Sweden
[2]Karolinska Institutet, Institute of Environmental medicine, Unit of Occupational medicine, Norrbacka, Stockholm, Sweden
[3]Helix Vinn Excellence Centre, Linköping University, Linköping 581 83, Sweden
关键词: Employers;    Subsidies;    Sweden;    Implementation;    Return to work;    Occupational health;   
Others  :  1162371
DOI  :  10.1186/1471-2458-13-310
 received in 2012-09-27, accepted in 2013-04-01,  发布年份 2013
PDF
【 摘 要 】

Background

In 2010, the Swedish government introduced a system of subsidies for occupational health (OH) service interventions, as a part in a general policy promoting early return to work. The aim of this study was to analyse the implementation of these subsidies, regarding how they were used and perceived.

Methods

The study was carried out using a mixed-methods approach, and comprises material from six sub-studies: a register study of the use of the subsidies, one survey to OH service providers, one survey to employers, one document analysis of the documentation from interventions, interviews with stakeholders, and case interviews with actors involved in coordinated interventions.

Results

The subsidized services were generally perceived as positive but were modestly used. The most extensive subsidy – for coordinated interventions – was rarely used. Employers and OH service providers reported few or no effects on services and contracts. OH service providers explained the modest use in terms of already having less bureaucratic routines in place, where applying for subsidies would involve additional costs. Information about the subsidies was primarily communicated to OH service providers, while employers were not informed.

Conclusions

The study highlights the complexity of promoting interventions through financial incentives, since their implementation requires that they are perceived by the stakeholders involved as purposeful, manageable and cost-effective. There are inherent political challenges in influencing stakeholders who act on a free market, in that the impact of policies may be limited, unless they are enforced by law.

【 授权许可】

   
2013 Ståhl et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150413063344706.pdf 316KB PDF download
Figure 1. 34KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Bültmann U, Sherson D, Olsen J, Hansen CL, Lund T, Kilsgaard J: Coordinated and tailored work rehabilitation: a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders. J Occup Rehabil 2009, 19(1):81-93.
  • [2]Loisel P, Buchbinder R, Hazard R, Keller R, Scheel I, van Tulder M, Webster B: Prevention of work disability Due to musculoskeletal disorders: the challenge of implementing evidence. J Occup Rehabil 2005, 15(4):507-524.
  • [3]Kärrholm J, Ekholm K, Ekholm J, Bergroth A, Ekholm KS: Systematic co-operation between employer, occupational health service and social insurance office: a 6-year follow-up of vocational rehabilitation for people on sick-leave, including economic benefits. J Rehabil Med 2008, 40(8):628-636.
  • [4]MacEachen E, Clarke J, Franche R-L: Systematic review of the qualitative literature on return to work after injury. Scand J Work Environ Health 2006, 32(4):257-269.
  • [5]Franche R-L, Cullen K, Clarke J, Irvin E, Sinclair S, Frank J, Cole D, Dacombe J, Guzman J, Hogg-Johnson S: Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil 2005, 15(4):607-631.
  • [6]Carroll C, Rick J, Pilgrim H, Cameron J, Hillage J: Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions. Disabil Rehabil 2010, 32(8):607-621.
  • [7]Williams RM, Westmorland MG, Lin CA, Schmuck G, Creen M: Effectiveness of workplace rehabilitation interventions in the treatment of work-related low back pain: a systematic review. Disabil Rehabil 2007, 29(8):607-624.
  • [8]MacEachen E, Kosny A, Ferrier S, Chamber L: The "toxic dose" of system problems: Why some injured workers Don't return to work as expected. J Occup Rehabil 2010, 20(3):349-366.
  • [9]Dekkers-Sánchez PM, Wind H, Sluiter JK, Frings-Dresen MHW: What promotes sustained return to work of employees on long-term sick leave? Perspectives of vocational rehabilitation professionals. Scand J Work Environ Health 2011, 37(6):481-493.
  • [10]Anema JR, Schellart AJM, Cassidy JD, Loisel P, Veerman TJ, van der Beek AJ: Can cross country differences in return-to-work after chronic occupational back pain be explained? An exploratory analysis on disability policies in a Six country cohort study. J Occup Rehabil 2009, 19(4):419-426.
  • [11]de Boer WEL, Brenninkmeijer V, Zuidam W: Long-term disability arrangements: a comparative study of assessments and quality control. Hoofddorp: TNO Work and Employment TNO; 2004.
  • [12]O'Hagan FT, Coutu MF, Thomas SG, Mertens DJ: Work reintegration and cardiovascular disease: medical and rehabilitation influences. J Occup Rehabil 2011, 22(2):207-281.
  • [13]Schmidt L, Sjöström J, Antonsson A-B: How can occupational health services in Sweden contribute to work ability? Work 2012, 41(Suppl. 1):2998-3001.
  • [14]Anema JR, Jettinghoff K, Houtman ILD, Schoemaker CG, Buijs PC, van den Berg R: Medical care of employees long-term sick listed Due to mental health problems: a cohort study to describe and compare the care of the occupational physician and the general practitioner. J Occup Rehabil 2006, 16(1):41-52.
  • [15]Rebergen DS, Bruinvels DJ, van der Beek AJ, van Mechelen W: Design of a randomized controlled trial on the effects of counseling of mental health problems by occupational physicians on return to work: the CO-OP-study. BMC Public Health 2007, 7:183. BioMed Central Full Text
  • [16]Pransky G, Benjamin K, Dembe AE: Performance and quality measurement in occupational health services: current status and agenda for further research. Am J Ind Med 2001, 40(3):295-306.
  • [17]The Swedish Work Environment Authority: The work environment 2009. 3rd edition. Stockholm: Swedish Work Environment Authority; 2010.
  • [18]Nilsing E, Söderberg E, Normelli H, Öberg B: Description of functioning in sickness certificates. Scand J Public Health 2011, 39(5):508-516.
  • [19]Lidwall U, Marklund S: Trends in long-term sickness absence in sweden 1992–2008: the role of economic conditions, legislation, demography, work environment and alcohol consumption. International Journal of Social Welfare 2011, 20(2):167-179.
  • [20]Ståhl C, Müssener U, Svensson T: Implementation of standardized time limits in sickness insurance and return-to-work: experiences of four actors. Disabil Rehabil 2012, 34(16):1404-1411.
  • [21]Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science 2009, 4(1):art. no. 50.
  • [22]Hill M, Hupe P: Implementing public policy: governance in theory and in practice. London: Sage; 2005.
  • [23]Hsieh H-F, Shannon S: Three approaches to qualitative content analysis. Qual Health Res 2005, 15(9):1277-1288.
  • [24]Patton MQ: Qualitative research and evaluation methods. 3rd edition. London: Sage; 2002.
  • [25]Lundquist L: Implementation steering. An actor-structure approach. Studentlitteratur: Lund; 1987.
  • [26]Greenhalgh T, Robert G, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004, 82(4):581-629.
  • [27]Rogers EM: Diffusion of innovations. 5th edition. New York: Free Press; 2003.
  • [28]Fixsen DL, Naoom SF, Blase KA, Friedman RM, Wallace F: Implementation research: a synthesis of the literature. Tampa: University of South Florida; 2005.
  • [29]Matland RE: Synthesizing the implementation literature: The ambiguity conflict model of policy implementation. Journal of Public Administration Research and Theory 1995, 5(2):145-174.
  • [30]World of Work Report: Income inequalities in the age of financial globalization. Geneva: International Labour Office; 2008.
  • [31]Tompa E, Scott-Marshall H, Dolinschi R, Trevithick S, Bhattacharyya S: Precarious employment experiences and their health consequences: towards a theoretical framework. Work 2007, 28(3):209-224.
  • [32]Underhill E, Quinlan M: How precarious employment affects health and safety at work: the case of temporary agency workers. Relations Industrielles 2011, 66(3):397-421.
  • [33]Tompa E, Hogg-Johnson S, Amick Iii BC, Wang Y, Shen E, Mustard C, Robson L, Saunders R: Financial incentives of experience rating in workers' compensation: New evidence from a program change in Ontario, Canada. J Occup Environ Med 2013, 55(3):292-304.
  • [34]Clayton S, Barr B, Nylen L, Burström B, Thielen K, Diderichsen F, Dahl E, Whitehead M: Effectiveness of return-to-work interventions for disabled people: a systematic review of government initiatives focused on changing the behaviour of employers. Eur J Public Health 2012, 22(3):434-439.
  • [35]van Raak A, de Rijk A, Morsa J: Applying new institutional theory: the case of collaboration to promote work resumption after sickness absence. Work, Employment & Society 2005, 19(1):141-151.
  • [36]Lipsky M: Street-level bureaucracy: dilemmas of the individual in public services. New York: Russell Sage; 1980.
  文献评价指标  
  下载次数:29次 浏览次数:53次