Vocational rehabilitation shows modest effectiveness according to a nationwide register-based study from Finland

Since 2004, access to vocational rehabilitation services has been a statutory right in Finland for persons who are assessed to have a threat of disability retirement within the next five years due to an illness or injury. The main services include work try-outs, work counselling, and training.

In a nationwide register-based study, difference in difference in work participation was assessed between individuals receiving work-oriented vocational rehabilitation and their propensity score matched controls not receiving vocational rehabilitation. The study included 3199 recently employed individuals aged 30–55 with a history of work disability due to a musculoskeletal disease or mental disorder starting vocational rehabilitation in 2008–2010 (intervention group), and 3199 non-rehabilitees (control group). Vocational rehabilitation resulted in a gain in work participation with a 7.2 (95% confidence interval 6.1–8.3) percentage point difference in difference between three years before and after the rehabilitation. For rehabilitation lasting up to 10 months, the gains tended to be short term, whereas for longer rehabilitation, they tended to be delayed. Women with musculoskeletal diseases showed the lowest gain.

Overall, vocational rehabilitation after work disability due to a musculoskeletal disease or mental disorder showed modest effectiveness on work participation. Alternative and complementary interventions should be considered. Sustained work participation after shorter rehabilitation, which likely comprises workplace interventions, may call for improved support that exceeds the time frame of the current vocational rehabilitation services. Faster work resumption after longer rehabilitation, which likely comprises training programmes, may require further support for employability.

Reference

Leinonen T, Viikari-Juntura E, Husgafvel-Pursiainen K, Juvonen-Posti P, Laaksonen M, Solovieva S. The effectiveness of vocational rehabilitation on work participation: a propensity score matched analysis using nationwide register data. Scand J Work Environ Health. 2019 Apr 12. pii: 3823. doi: 10.5271/sjweh.3823.

Contact: Professor Eira Viikari-Juntura (eira.viikari-juntura@ttl.fi)

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