"Fit for work and life": an innovative concept to improve health and work ability of employees, integrating prevention, therapy and rehabilitation
Christoph Gutenbrunner, Juliane Briest, Christoph Egen, Christian Sturm, Jörg Schiller, Kai G. Kahl, Uwe Tegtbur, Heike Fuhr, Christoph Korallus
Hanover Medical School, Department of Rehabilitation Medicine, Carl-Neuberg-Str. 1, DE-30625 Hannover, Germany.
Objectives: To set up a comprehensive health programme for employees, with needs-based allocation to preventive and rehabilitative measures; and to evaluate the effects of the programme on work ability and sick leave.
Design: Prospective single-group observational study.
Methods: Employees of a university hospital were invited to participate in needs-based interventions of preventive or rehabilitative character. Allocation followed screening questionnaires, anamnesis and clinical examination. The selection of a preventive or rehabilitative measure appropriate to the needs of the patient followed screening questionnaires, anamnesis and clinical examination. Preventive offers can include back training courses, water gymnastics or stress management exercises. Rehabilitative measures can include 3-6 weeks in- or outpatient rehabilitation or one week intensive outpatient rehabilitation. The main outcome parameters were work ability and sick leave duration.
Results: At this time of the project included 1,547 participants, who applied voluntarily to enter the programme. The mean age of participants was 44.3 years (standard deviation (SD) 10.3 years), and 72.0% were female. Needs-based allocation to a prevention (n=1,218) or a rehabilitation group (n=329) was effective, and enabled formation of 2 groups with different needs. Overall, more than half of the employees participating in the programme reported sick leave within the last 3 months. Participants in the preventive measures group reported significantly lower duration of sick leave than those in the rehabilitation group. Employees in the rehabilitation group had significantly lower work ability (Work Ability Index (WAI) 30.4 vs 36.6), but higher effects at 6-month follow-up (WAI 33.4 (standardized effect size (SES) 0.51) vs 37.9 (SES 0.17)). In the prevention group mean sick leave reduced significantly from 1.9 to 1.3 weeks (p < 0.001) during the previous 3-month period, whereas in the rehabilitation group it reduced from 2.7 to 1.5 (p < 0.001) weeks.
Conclusion: Implementation of the comprehensive health programme was successful, using the multimodal infrastructure of a university hospital. Allocation to suitable interventions in occupational health programmes following screening, anamnesis and clinical examination is an appropriate way to meet participants’ needs. The programme resulted in improved work ability and less sick leave.
Occupational health programmes are important to improve and maintain employees’ health and work ability. Each employee has an individual need for measures, and meeting those needs can be the key to improving their situation. Allocation to different preventive or, if necessary, rehabilitative measures, in the comprehensive programme “Fit for Work and Life”, was performed by a doctor after obligatory consultation. This ensured the best possible effects of the invested resources. Participants allocated to rehabilitation measures had lower initial work ability and higher sick leave durations, but showed higher improvements in outcome parameters than participants in the preventive group.
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