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Evaluation of a case management service to reduce sickness absence

Evaluation of a case management service to reduce sickness absence
Evaluation of a case management service to reduce sickness absence
It is unclear whether and to what extent intensive case management is more effective than standard occupational health services in reducing sickness absence in the health care sector. Our aim is to evaluate a new return to work service at an English hospital trust. The new service entailed intensive case management for staff who had been absent sick for longer than 4 weeks, aiming to restore function through a goal-directed and enabling approach based on a bio-psycho-social model. Assessment of the intervention was by controlled before and after comparison with a neighbouring hospital trust at which there were no major changes in the management of sickness absence. Data on outcome measures were abstracted from electronic databases held by the two trusts. At the intervention trust, the proportion of 4-week absences that continued beyond 8 weeks fell from 51.7% in 2008 to 49.1% in 2009 and 45.9% in 2010. The reduction from 2008 to 2010 contrasted with an increase at the control trust from 51.2% to 56.1%—a difference in change of 10.7% (95% CI 1.5–20.0%). There was also a differential improvement in mean days of absence beyond 4 weeks, but this was not statistically significant (1.6 days per absence; 95% CI ?7.2 to 10.3 days). Our findings suggest that the intervention was effective, and calculations based on an annual running cost of £57 000 suggest that it was also cost-effective. A similar intervention should now be evaluated at a larger number of hospital trusts.
case management, cost-effectiveness, evaluation, health care, intervention, sickness absence
0962-7480
89-95
Smedley, J.
93ab0e57-e127-4367-a8b6-4814177e1f39
Harris, E.C.
3e4bd946-3f09-45a1-8725-d35e80dd7971
Cox, V.
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Ntani, G.
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Coggon, D.
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Smedley, J.
93ab0e57-e127-4367-a8b6-4814177e1f39
Harris, E.C.
3e4bd946-3f09-45a1-8725-d35e80dd7971
Cox, V.
ff42143b-7eb8-4573-9bdf-ca3ade40a634
Ntani, G.
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Coggon, D.
2b43ce0a-cc61-4d86-b15d-794208ffa5d3

Smedley, J., Harris, E.C., Cox, V., Ntani, G. and Coggon, D. (2013) Evaluation of a case management service to reduce sickness absence. Occupational Medicine, 63 (2), 89-95. (doi:10.1093/occmed/kqs223). (PMID:23365116)

Record type: Article

Abstract

It is unclear whether and to what extent intensive case management is more effective than standard occupational health services in reducing sickness absence in the health care sector. Our aim is to evaluate a new return to work service at an English hospital trust. The new service entailed intensive case management for staff who had been absent sick for longer than 4 weeks, aiming to restore function through a goal-directed and enabling approach based on a bio-psycho-social model. Assessment of the intervention was by controlled before and after comparison with a neighbouring hospital trust at which there were no major changes in the management of sickness absence. Data on outcome measures were abstracted from electronic databases held by the two trusts. At the intervention trust, the proportion of 4-week absences that continued beyond 8 weeks fell from 51.7% in 2008 to 49.1% in 2009 and 45.9% in 2010. The reduction from 2008 to 2010 contrasted with an increase at the control trust from 51.2% to 56.1%—a difference in change of 10.7% (95% CI 1.5–20.0%). There was also a differential improvement in mean days of absence beyond 4 weeks, but this was not statistically significant (1.6 days per absence; 95% CI ?7.2 to 10.3 days). Our findings suggest that the intervention was effective, and calculations based on an annual running cost of £57 000 suggest that it was also cost-effective. A similar intervention should now be evaluated at a larger number of hospital trusts.

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e-pub ahead of print date: 30 January 2013
Published date: March 2013
Keywords: case management, cost-effectiveness, evaluation, health care, intervention, sickness absence
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 354120
URI: http://eprints.soton.ac.uk/id/eprint/354120
ISSN: 0962-7480
PURE UUID: fe17923a-5689-4564-938a-a36b7663625f
ORCID for E.C. Harris: ORCID iD orcid.org/0000-0001-8037-566X
ORCID for D. Coggon: ORCID iD orcid.org/0000-0003-1930-3987

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Date deposited: 01 Jul 2013 13:53
Last modified: 18 Feb 2021 16:47

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Contributors

Author: J. Smedley
Author: E.C. Harris ORCID iD
Author: V. Cox
Author: G. Ntani
Author: D. Coggon ORCID iD

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