RR493 - The costs and benefits of active case management and rehabilitation for musculoskeletal disorders
The cost of musculoskeletal disorders (MSDs) to employers is significant, with the most substantial cost component
being lost time from work. This study sought to identify the evidence on cost-effective case management and
rehabilitation principles for MSDs that could be applied by employers and healthcare providers to help those with
MSDs stay in work or return to work.
An extensive literature review was undertaken which focused on high quality international scientific studies. There is
good evidence that case management methods are cost-effective and stronger evidence that best practice
rehabilitation approaches have potential to significantly reduce long term sickness absence. The review identified that
programmes using case management and rehabilitation principles can be an effective intervention, and have been
widely adopted in various industrialised countries. The key components for successful programmes were identified
from the literature. Consultation (questionnaire and focus groups) with UK healthcare professionals and organisations
indicated that a wide range of programmes were being implemented, although the structure and scope varied. Over a
third of respondents had started their programmes in the last three years. The programmes were perceived to be
effective, although few had cost benefit information to support this. Where organisations did have information on the
costs and benefits of their programmes this suggested that they are cost effective. Through discussion with
organisations the practicality of implementing these programmes, and obstacles to doing so, were identified.
An evidence-base model for managing workers with MSDs was developed based on this information. Consultation on the
model with potential users suggested that it would be useful, and minor modifications were made to it based on feedback.
The model is generally applicable to all types of organisation in the UK, and is relevant for all types of MSDs. It describes the
principles to apply in order to integrate case management and rehabilitation with the workplace. This report includes the
model and details the research that led to its development.
This report and the work it describes were funded by the Health and Safety Executive (HSE). Its contents,
including any opinions and/or conclusions expressed, are those of the author alone and do not necessarily
reflect HSE policy.
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