I Vaananen-Tomppo et al. International Journal of Rehabilitation Research. September (2001) Vol.24 #3. p 171.
State employees in Finland have access to rehabilitation services at their usual place of work. The gatekeeper is a fully qualified occupational physician or psychologist, as appropriate. The trigger is any report of a threat to the ability to perform normal duties. Very often the service is triggered before deterioration to the extent that the employees requires time off work. Interventions and return to work programmes take place at the usual place of work.
This study was designed to assess the cost benefit ratio of this system. The reference population consisted of those who did not ask for help, but went off sick.
The analysis presented here is hard to understand, but suggests a cost benefit ratio of between 1 and 5.
Rehabilitation champions in the UK often propose a design which uses nurses, occupational therapists and physiotherapists as the gate keepers, perhaps this presumption merits further thought?
Intervention before sickness absence, appears to be supported here.