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Fit For Work EuropeThe Work Foundation

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Discourse on work and wellbeing in the EU

Archive for May, 2014

Making the economic case for Early Intervention with MSDs

Tuesday, May 20th, 2014

Last month I spoke at the 1st Macedonian and 4th Adriatic Congress on Pharmacoeconomics and Outcomes Research in the beautiful resort of Ohrid in Macedonia. The Congress examined a range of topics relating to healthcare decision-making in the lower-income countries of the Adriatic and Balkans region. These included the contribution of health insurance to the cost-effective use of medicines, the health economics of personalised medicines and case studies of health technology assessment practices (HTA) in Serbia, Croatia and Bosnia and Herzegovina (Fit for Work has also conducted a series of case studies on the Societal Perspective in HTA).

Days lost to MSDs in Slovenia

Days lost to MSDs in Slovenia

My presentation focused on the issue of early healthcare interventions which promote workability and labour market participation. I used Musculoskeletal Disorders (MSDs) as an example and also focused on the Fit for Work research we have conducted in Slovenia to illustrate my conclusions.

In Slovenia, as illustrated by the graph below, MSDs account for a very large proportion of days lost to sickness absence – 2.5 million each year.

Almost 49 per cent of Slovenian workers report work-related back pain, and over 38 per cent of Slovenian workers report that they have experienced muscular pain in their neck, shoulders and upper limbs. There are over 13,000 people with RA – with an annual cost of treatment of €126m. Unlike some countries, the social insurance system in Slovenia extends support to people with MSDs which are not caused by work or workplace injuries (unlike some Worker Compensation schemes around the world). This means that vocational rehabilitation is an important priority. However, there can be delays in accessing treatment which supports return to work (eg physiotherapy, spa therapy, drug treatments) because referral rates to secondary care – especially Orthopaedic specialists in the case of people with MSDs – by GPs are very high, causing long waiting times. As yet GPs in Slovenia – as in most countries – do not have any incentive to regard work as a clinical outcome of care or as a commissioning priority. In addition, there are few incentives in the welfare system for people to remain in work as the disability replacement wage rate id quite high.

My presentation, however, indicated that earlier intervention for Slovenian workers with MSDs could result in an additional 2,800 being available for work each day. This estimate was derived from data produced by Dr Juan Angel Jover and his colleagues in Madrid where an early intervention clinic for people with MSDs reduced temporary work disability by 39 per cent. With the potential for such significant increases in productive capacity and human capital utilisation, I argued that the economic and social benefits of early clinical interventions should be disseminated widely to clinicians and healthcare decision-makers.

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Fit for Work Korea research launched in National Assembly in Seoul

Tuesday, May 6th, 2014

As the Fit for Work programme extends beyond its western European origins it has been fascinating to explore how different countries manage the consequences of chronic ill-health in their working age populations. Earlier this month, I had the pleasure of attending the launch of the Fit for Work report in Seoul. Like many other Asia-Pacific countries, Korea faces a number or pressing demographic and labour market challenges such as ageing which will have profound economic and social consequences. For the research underpinning the Korean report The Work Foundation partnered with Prof Sunwon Kwon and Prof Jongwook Won who, with colleagues, reviewed the Korean literature and data sources on musculoskeletal disorders (MSDs) and drafted the report.

Prof Bevan speaking at the launch of the Fit for Work Korea

Prof Bevan speaking at the launch of the Fit for Work Korea

Prof Kwon represents the Graduate School of Business at Sookmyung Women’s University and is an expert in labour relations. Prof Won has a background in occupational medicine and is based at the school of medicine at Yonsei University. The excellent final report was launched at a well-attended seminar hosted in the National Assembly in Seoul, hosted by two eminent members of the Assembly – Congresswoman Jaongae Han (member of the labour Committee) and Congressman Yongik Kim (member of the Health & Welfare Committee).

Core findings from the Fit for Work research in Korea show that:

  • The proportion of the total number of compensated occupational diseases in Korea accounted for by MSDs increased from 49.6 per cent in 2003 to 76.5 per cent in 2007.
  • The total cost of work-related MSDs increased from ₩105.3 billion in 2004 to ₩163.3 billion in 2007.
  • People with MSDs accounted for 69.2% of the total of all occupational diseases in 2010
  • The most common condition requiring more than one day of absence from work (caused by or exacerbated by work) was MSDs in the upper limbs (31.2%), followed by MSDs in the lower limbs (13.9%) and lumbar spine (6.9%),
  • MSDs caused directly by working conditions increased from 26.6% of all cases in 2006 to 33.4% of all cases in 2009
  • According to 2012 National Health Insurance Statistics, 14.87 million people received treatment for MSDs, accounting for 32.5% of total treatment across all conditions.
  • MSDs are the biggest cause of absence from work in Korea and account for no less than 52% of overall disorders.
The launch of the Fit for Work Coalition in Korea

The launch of the Fit for Work Coalition in Korea

The ageing labour force in Korea, together with low rates of labour productivity, are key characteristics of the labour market which policy-makers in Seoul are focused on and the Fit for Work research shines a light on the need to prioritise the health and work ability of the Korean workforce as it becomes more susceptible to chronic health problems.

However, I was convinced that opinion-leaders and policy-makers in Korea are increasingly aware of the need to take action and I am confident that the Fit for Work Korea report will make a significant contribution to the debate in the immediate future. I am hopeful that a Korean Fit for Work Coalition will soon be established to ensure that the findings and recommendations of the report influence the debate on workforce health in Korea.

The Fit for Work report on Musculoskeletal Disorders and the labour market in Korea will soon be published on the Fit for Work website.

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Posted in Asia-Pacific, Health Policy, Labour policy, Musculoskeletal Disorders | Comments Off on Fit for Work Korea research launched in National Assembly in Seoul
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