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[The effectiveness and costs of the Back At work After Surgery (BAAS) work-integrated care pathway on return to work
Daniël O Strijbos1,2, Geert van der Sluis3, Tim Boymans4
1Amsterdam UMC, afd. Public & Occupational Health, Amsterdam.
Objective:
To evaluate the effectiveness and costs of the Back At work After Surgery (BAAS) integrated care pathway for workers receiving knee arthroplasty in the Netherlands.
Design:
Comparative cohort study of the BAAS cohort versus two usual-care cohorts.
Methods:
BAAS included explicit discussion of RTW in orthopedic consultations, workplace assessment, Goal Attainment Scaling, activity monitoring and an interdisciplinary online consult at 4-5 weeks postoperatively. Cohorts shared similar inclusion criteria and return-to-work and cost outcomes. Time to (full) RTW was analyzed with IPTW/Cox regression and costs with propensity score matching.
Results:
Median time to first RTW was 27 days in BAAS versus 52 and 43 days in controls (HR 2.7 and 1.95). Full RTW took 183 versus 210 days (HR 1.4). Non-RTW within 12 months was 2% versus 16% and 13%. Intervention cost €845 with cost reductions of €4,493 per worker from employer perspective.
Conclusion:
BAAS accelerates return-to-work and delivers substantial economic benefits.

