Qualitative evaluation of a form for standardized information exchange between orthopedic surgeons and occupational physicians

BACKGROUND: Both occupational physicians and orthopedic surgeons can be involved in the management of work relevant musculoskeletal disorders. These physicians hardly communicate with each other and this might lead to different advices to the patient. Therefore, we evaluated a standardized information exchange form for the exchange of relevant information between the orthopedic surgeon and the occupational physician. The main goals of this qualitative study are to evaluate whether the form improved information exchange, whether the form gave relevant information, and to generate ideas to further improve this information exchange. METHODS: The information exchange form was developed in two consensus meetings with five orthopedic surgeons and five occupational physicians. To evaluate the information exchange form, a qualitative evaluation was set up. Structured telephone interviews were undertaken with the patients, interviews with the physicians were face-to-face and semi-structured, based on a topic list. These interviews were recorded and literally transcribed. Each interview was analyzed separately in Atlas-Ti. RESULTS: The form was used for 8 patients, 7 patients agreed to participate in the qualitative evaluation. All three orthopedic surgeons involved and three of the six involved occupational physicians agreed to be interviewed. The form was transferred to 4 occupational physicians, the other 3 patients recovered before they visited the occupational physician. The information on the form was regarded to be useful. All orthopedic surgeons agreed that the occupational physician should take the initiative. Most physicians felt that the form should not be filled out for each patient visiting an orthopedic surgeon, but only for those patients who do not recover as expected. Orthopedic surgeons suggested that a copy of the medical information provided to the general practitioner could also be provided to occupational physicians. CONCLUSION: The information exchange form was regarded to be useful and could be used in practice. The occupational physician should take the initiative for using this form and most physicians felt the information should only be exchanged for patients who do not recover as expected. That means that the advantage of giving information early in the treatment is lost

The dimensional structure of the functional abilities in cases of long-term sickness absence

<p>Abstract</p> <p>Background</p> <p>The health problems that working people suffer can affect their functional abilities and, consequently, can cause a mismatch between those abilities and the demands of the work, leading to sickness absence. A lasting decrease in functional abilities can lead to long-term sickness absence and work disability, with negative consequences for both the worker and the larger society. The objective of this study was to identify common disability characteristics among large groups of long-term sick-listed and disabled employees.</p> <p>Methods</p> <p>As part of the disability benefit entitlement procedure in the Netherlands, an insurance physician assesses the functional abilities of the claimant in a standardised form, known as the List of Functional Abilities (LFA), which consists of six sections containing a total of 106 items. For the purposes of this study, we compiled data from 50,931 assessments. These data were used in an exploratory factor analyses, and the results were then used to construct scales. The stability of dimensional structure of the LFA and of the internal consistency of the scales was studied using data from 80,968 assessments carried out earlier, under a slightly different legislation.</p> <p>Results</p> <p>Three separate factor analyses carried out on the functional abilities of five sections of the LFA resulted in 14 scale variables, and one extra scale variable was based on the items from the sixth section. The resulting scale variables showed Cronbach's Alphas ranging from 0.59 to 0.97, with the exception of one of 0.54. The dimensional structure of the LFA in the verification population differed in some aspects. The Cronbach's Alphas of the verification population ranged from 0.58 to 0.97, again with the exception of the same scale: Alpha = 0.49.</p> <p>Conclusion</p> <p>The differences between the dimensional structures of the primary data and the earlier data we found in this study restrict the possibilities to generalise the results. The scales we constructed can be utilised to produce a compact description of the functional abilities of groups of claimants in the Netherlands. Moreover, the matching work demands can be used to identify jobs low on those demands as being the most accessible for the specific type of disabled employees, particularly severely disabled individuals.</p

Prevention of recurrent sickness absence among employees with common mental disorders: design of a cluster-randomised controlled trial with cost-benefit and effectiveness evaluation

BACKGROUND: Common mental disorders, such as depression, anxiety disorder, and adjustment disorder, have emerged as a major public and occupational health problem in many countries. These disorders can have severe consequences such as absenteeism and work disability. Different interventions have been developed to improve the return-to-work of employees with common mental disorders, but still a large proportion of employees experiences health and work problems after their return-to-work. For this reason, the SHARP-at work intervention is developed to prevent a relapse of sickness absence among employees who have returned to work after a period of sickness absence because of common mental disorders. We aim to evaluate the effectiveness, cost-benefit and process of the intervention compared to care as usual. METHODS/DESIGN: The study is designed as a cluster-randomised controlled trial with randomisation at the level of the occupational physician. Employees who have returned to work after a period of sickness absence because of a common mental disorder are included in the study. Employees in the intervention group will receive the SHARP-at work intervention. The intervention focusses on active guidance of employees by occupational physicians during the first weeks of work after sickness absence. Employees in the control group will receive care as usual. Outcomes will be assessed at baseline and at 3, 6, and 12 months follow-up. The primary outcome is cumulative recurrent sickness absence days. Secondary outcome measures are mental health, work functioning, and coping. Adherence to the protocol, communication between stakeholders, and satisfaction with the treatment are the process measures assessed in both study groups. Cost-benefit is calculated from a societal perspective. Finally, prognostic factors for a relapse of sickness absence are investigated. DISCUSSION: This study goes beyond return-to-work by focussing on the prevention of recurrent sickness absence. The study incorporates not only outcomes on sickness absence and mental health but also on health-related work functioning. The results of this study can contribute to a further development of practice guidelines and the promotion of sustainable work participation. TRIAL REGISTRATION: NTR1963

Periodieke Informatie ArbeidsongeschiktheidsVerzekeringen

Administratieve gegevens betreffende de nieuwe, beëindigde en lopende uitkeringen, onder meer verdeeld naar sector, leeftijd, geslacht, mate van arbeidsongeschiktheid en diagnose. PIAV is een beschrijving van de gegevensset WAO/WAZ/WAJONG zoals die is opgeslagen in het UWV datawarehouse. Het datawarehouse is de gegevensbron voor diverse rapportages/bestandsleveringen richting externe partijen zoals bijvoorbeeld de Atlas SV. PIAV data zijn niet via de website uwv.nl benaderbaar

Atlas SV-regionale informatie sociale verzekeringen

Het UWV zorgt voor de landelijke uitvoering van de werknemersverzekeringen en voor arbeidsmarkt- en gegevensdienstverlening. Dat doet het UWV als zelfstandig bestuursorgaan (ZBO) in opdracht van het Ministerie van Sociale Zaken en Werkgelegenheid. De Atlas SV omvat statistische gegevens betreffende de nieuwe, beëindigde en lopende uitkeringen AG en WW, per provincie en gemeenten onderverdeeld naar onder meer leeftijd, geslacht en uitkeringsduur

Epidemiologie van de arbeidsongeschiktheid 1998-2001

Veranderingen in wet- en regelgeving rond arbeidsongeschiktheid zijn van invloed op de werknemers die bij UWV (of haar voorgangers) een beroep moeten doen op de betreffende voorzieningen. Met de reguliere statistieken worden niet alle relevante kenmerken van deze ‘cliënten’ in kaart gebracht, waardoor onvoldoende zicht wordt verkregen op de gevolgen van de wetswijzigingen. In de epidemiologieonderzoeken wordt daarom aanvullende informatie verzameld via enquêtes bij de cliënten zelf. De epidemiologieonderzoeken bestaan sinds 1985. Sindsdien zijn meerdere cohorten gevolgd, waarvan het meest recente in 2007 (Weg naar WIA) en 2012 (Weg naar WIA II - juni 2012 gestart). De overige cohorten betreffen personen die in respectievelijk 1987, 1991, 1994, 1998, 1999 en 2001 het einde van de wachttijd voor de WAO bereikt hebben. De algemene doelstelling van de epidemiologieonderzoeken kan op de volgende wijze worden beschreven: Een systematische beschrijving van een representatieve groep 12-maandszieken op demografische en sociaal-economische kenmerken, op kenmerken van het oude werk en de oude werkgever, op diverse aspecten van de gezondheid, WAO-claimbeoordeling en begeleiding, bemiddeling en reïntegratie. Bij deze beschrijving is vergelijking van deze gegevens binnen dezelfde cohorten, en met vorige en toekomstige cohorten mogelijk. Vanwege de gewenste vergelijkbaarheid komen dezelfde enquêtevragen terug in de verschillende cohorten en in de verschillende metingen daarbinnen. De specifieke onderzoeksvraagstellingen variëren echter per deelproject en worden ingegeven door de op dat moment bestaande behoefte aan beleidsinformatie