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*

Objective: To evaluate the effects of systematic co-operation among municipal employees on the number of sick-leave days per month and the type of benefit granted by the Social Insurance Office. A further aim was to evaluate the econom ic consequences for society. Design: A 6-year follow-up study with a matched-pairs design. Methods: Days on sick-leave were calculated for each subject one year before the intervention started and yearly for the following 6-year period. Statistical mixed-model analysis was used. The economic benefit of the intervention was es timated as the increased production stemming from fewer days on sick-leave. Subjects: Sixty-four employees on long-term sick-leave were individually matched with controls from another Social Insurance Office in a county with a socioeconomic structure similar to that of the study group. Results: The study group had 5.7 fewer days on sick-leave per month and person over the 6-year period (p = 0.003). The estimated average economic benefit of the intervention was €36,600 per person over the 6-year period. In conclusion, those who received systematic co-operation in vocational rehabilitation had fewer days on sick-leave than their “treatment-as-usual” peers. This effect persisted over 6 years, generating substantial net economic gains for society.