The costs and benefits of active case management and rehabilitation for musculoskeletal disorders

Abstract

The burden of musculoskeletal disorders (MSDs) to employers and workplaces is significant; and the most important cost to employers and society is lost time from work. ‘Case management’ is a goal-oriented approach to keeping employees at work and facilitating an early return to work. There is good scientific evidence that case management methods are costeffective through reducing time off work and lost productivity, and reducing healthcare costs. There is even stronger evidence that best-practice rehabilitation approaches have the very important potential to significantly reduce the burden of long-term sickness absence due to MSDs. The combination of case management with suitable rehabilitation principles is currently being used effectively in multiple settings throughout the UK, and there is growth within the case management sector. Current providers vary widely in quality and experience. There is limited professional regulation, although localised standards of practice have recently become available. Many of the factors influencing the adoption of cost-effective case management and rehabilitation approaches rest with employers, and funders/commissioners of healthcare. It may be easier to integrate these practices into large and medium-sized workplaces, but there is no reason why the same principles cannot be applied to small businesses and the self-employed. It appears to be very timely for the distribution of information to employers and other key players about how effective case management and suitable rehabilitation approaches can be, and how applicable they are to UK settings. To this end, an integrated model specific to the UK has been developed. An evidence-based model for managing those with MSDs was developed that is widely applicable to all types of industry and business in the UK. It describes the principles to apply in order to integrate case management and rehabilitation with the workplace. It was derived from high quality scientific studies, and research conducted into views on the applicability and effectiveness within the UK. It is recommended that HSE distribute guidance based on this model