Components of primary care multimodal rehabilitation and their association with changes in sick leave: An observational study.

BACKGROUND: To address the increase in sick leave for nonspecific chronic pain and mental illness, the Swedish government and the Swedish Association of Local Authorities and Regions entered into an agreement on a "Rehabilitation Guarantee" to carry out multimodal rehabilitation (MMR). OBJECTIVE: To...

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Publicado en:Work Vol. 74; no. 3; pp. 907 - 918
Autores principales: Severinsson, Yvonne, Grimby-Ekman, Anna, Nordeman, Lena, Holmgren, Kristina, Käll, Lina Bunketorp, Dottori, Maria, Larsson, Maria EH
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2023
      vid: 74
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        atl: Components of primary care multimodal rehabilitation and their association with changes in sick leave: An observational study.
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        au:
          Severinsson, Yvonne
          Grimby-Ekman, Anna
          Nordeman, Lena
          Holmgren, Kristina
          Käll, Lina Bunketorp
          Dottori, Maria
          Larsson, Maria EH
        affil: Department of Orofacial Pain, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
      sug:
        subj:
          Rehabilitation
          Primary Health Care
          Sick Leave Evaluation
          Funding Source
          Human
          Nonexperimental Studies
          Descriptive Statistics
          Data Analysis Software
          Retrospective Design
          Surveys
          Cross Sectional Studies
          Confidence Intervals
          Odds Ratio
          Sweden
          Male
          Female
          Young Adult
          Adult
          Middle Age
          Aged
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: BACKGROUND: To address the increase in sick leave for nonspecific chronic pain and mental illness, the Swedish government and the Swedish Association of Local Authorities and Regions entered into an agreement on a "Rehabilitation Guarantee" to carry out multimodal rehabilitation (MMR). OBJECTIVE: To investigate whether components of primary care MMR are associated with changes in sick leave. METHODS: A web-based survey was conducted in conjunction with a retrospective cross-sectional observational study of 53 MMR units. Sick leave data for the years before and after MMR completion was collected for 846 individuals. RESULTS: There was great disparity in how MMR was delivered. The average duration of rehabilitation was 4–8 weeks, and 74% of the MMR teams reported having fewer patients than recommended (≥20/year). Only 58% of the teams met the competence requirements. In-depth competence in pain relief and rehabilitation was reported by 45% of the teams and was significantly associated with fewer sick leave days after MMR (26.53, 95% CI: 3.65; 49.42), as were pain duration (17.83, 95% CI: –9.20; 44.87) and geographic proximity (23.75, 95% CI: –5.25; 52.75) of the health care professionals included in the MMR unit. CONCLUSIONS: In-depth competence and knowledge about the complex health care needs of patients seem essential to MMR teams' success in reducing sickness benefits for patients with nonspecific chronic pain and mental illness. Further research is needed to elucidate the optimal combination of primary care MMR components for increasing the return-to work rate and to determine whether involvement of the Social Insurance Agency or employers could support and further contribute to recuperation and help patients regain their previous work capacity.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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