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Evidence-informed decision about (de-)implementing return-to-work coordination to reduce sick leave: a case study.

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Return to work (RtW) coordination interventions show no significant effect on sick leave, according to a Cochrane review. De-implementation in Finland is deemed unnecessary, but more data on costs and stakeholder values is required for better decision-making.

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Area of Science:

  • Occupational health
  • Health services research
  • Evidence-based practice

Background:

  • A Cochrane review found limited effectiveness of return to work (RtW) coordination on workers' sick leave compared to usual care.
  • The study examines the applicability of this evidence to country-specific RtW practices, using Finland as a case study.

Purpose of the Study:

  • To analyze how evidence from a Cochrane review on RtW coordination can inform decisions regarding its implementation or de-implementation in Finland.
  • To compare Finnish RtW practices with interventions evaluated in the Cochrane review.

Main Methods:

  • Systematic literature search and an online expert survey were conducted.
  • Content analysis and the evidence-to-decision (EtD) framework were applied to compare interventions and draw conclusions.
  • Benefits, harms, and costs of RtW coordination versus usual care were assessed.

Main Results:

  • RtW coordination in Finland and the review share core components like physician-worker meetings and individual RtW plans.
  • Evidence supporting the Cochrane review interventions is of low certainty, with wide confidence intervals.
  • The EtD framework did not support further implementation or de-implementation of RtW coordination in Finland.

Conclusions:

  • RtW coordination interventions in Finland are comparable to those in the Cochrane review.
  • De-implementation of RtW coordination in Finland is not supported, considering current evidence and costs.
  • Improved data on costs and stakeholder values are necessary for enhanced decision-making regarding RtW coordination.