Disability management interventions provide economic and health outcome benefits
Take Home Messages:
- The benefits of a disability management program include reduced health care costs, reduced wage replacement costs, as well as administrative and indirect costs.
- There are costs in setting up and running a disability management program, including wages of the return to work coordinator, costs in setting up reporting, and other staffing.
- A broad range of studies across many countries have shown the financial benefits of work disability programs outweigh the costs. And that is before the workplace culture benefits are taken into account.
Why the research matters:
Many studies show disability management interventions are effective in helping people get back to work. However, there has been little information on the economic benefits of these programs.
What the research involved:
Tompa and colleagues from the Institute for Work and Health in Canada completed a major review of the published literature to examine the cost benefits of workplace interventions. They looked at research dating back to 1990 and identified 17 disability management intervention studies that included an economic evaluation of the effects of the intervention.
Summary of research findings:
Of the seventeen studies identified, eight were judged to be of medium or high quality and were included in the review. The studies were undertaken across a range of industry sectors, and were conducted in Canada, the United States of America, Finland or Sweden.
The majority of the studies reviewed used a cost-benefit method of economic analysis, where the costs and benefits of the intervention were compared in monetary units. The most common economic outcome measures used were wage-replacement expenses associated with the injury absence and the healthcare expenses associated with treatment of the injury.
Their key finding was that disability management interventions generate positive economic outcomes.
The researchers examined the economic benefits of disability management interventions according to industry sector, the components, and specific features of the intervention.
Industry sector
Although the studies included in the review were undertaken in five industry sectors, there were insufficient data to draw conclusions regarding the economic merits of disability management interventions in specific industries. However, there was strong evidence of the economic benefits of disability management programs in the multi-sector setting. Three of the four studies undertaken in this context demonstrated a financial benefit associated with the intervention.
Components of the intervention
On evaluating the various components of the disability management interventions reported in the studies, the researchers found moderate evidence supporting the economic benefits of:
- Ergonomics or other education component (5 studies)
- Physiotherapy (3)
- Work or vocational rehabilitation (2)
In contrast, there was only limited evidence that interventions with a behavioural component offered an economic benefit (2 studies).
No one intervention component stood out as the major factor in the positive financial outcome.
Features of the interventions
With regard to the key features of the interventions, the researchers found evidence supporting the economic merits of:
- Early contact with the worker by their workplace
- Offer of work accommodation
- Contact between healthcare provider and workplace
- Ergonomic work site visits
- Coordination of return-to-work
While it is well documented that such interventions achieve positive health outcomes for the injured worker, this study demonstrates that disability management interventions also provide financial benefits.
In the course of their literature search, the researchers make a number of recommendations for improving the economic analysis of interventions. Systematic evaluation of the economic merits of disability management interventions will assist policy and decision-makers to more effectively allocate limited healthcare resources.
Original research:
A systematic review of disability management interventions with economic evaluations.
Tompa E, de Oliveira C, Dolinschi R, Irvin E.
Journal of Occupational Rehabilitation 2008;18(1): 16-26.