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Fit For Work EuropeThe Work Foundation

Fit EU Blog

Discourse on work and wellbeing in the EU

Posts Tagged ‘sickness absence’

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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Widening the gap of inequality. MSD – the forgotten non-communicable disease.

Thursday, February 6th, 2014

DG SANCO announced that it is going to host a summit in Brussels this April to debate innovative solutions to the growing burden of chronic diseases on the health care systems and the economy. Surprisingly enough, musculoskeletal disorders are not on their agenda. A door slammed in the face of 100 million European citizens suffering from musculoskeletal pain – one might say. To give you an idea of the dimensions of the problem, this figure is comparable with the aggregated population of Belgium, Germany and Austria. Actually, in excess of 40 million people are of working-age and have an MSD cause by their work. To make things worse, evidence-based studies conducted within Fit for Work Europe, through The Work Foundation, and elsewhere by organisations such as Eumusc.net and even the European Commission, show that the EU economy loses €240bn to MSD annually. MSD is also the leading cause of sickness absence in the EU, accounting for half of all absences from work lasting three days or longer and 60% of permanent job loss.

Yet the European institutions seem to have turned a blind eye to MSDs. Neither the European Commission, nor the World Health Organisation classifies MSDs as serious non-communicable diseases. Why is that? One can speculate that MSDs, unlike cancer, diabetes or cardiovascular diseases, are not considered to be a major cause of death. It is a fact, though, that MSDs can seriously contribute to the increase of mortality rates. People living with an MSD incur the risk of developing other conditions such as mental health problems – 30% of people with MSDs also have depression – obesity and cardiovascular diseases.

Allegedly, policy-makers have given little priority to MSDs because of insufficient cross-country data. One might argue that most people with MSDs are treated in outpatient settings and that most health information systems are rather designed to provide data about inpatient care.  It could also be claimed that MSD diagnoses are recorded differently in various member states, which makes it difficult to draw comparable conclusions. However, in recent years considerable progress has been made in capturing and processing comprehensive data related to MSDs. To name just a few sources, the Global Burden of Diseases and Eumusc.net have released hefty reports on the societal and economic impact of MSDs.

In addition, Fit for Work Europe has been working for five years now to promote the prioritisation of MSDs amongst the most harmful non-communicable diseases and the implementation of healthcare and workplace interventions that support  job retention and return to work for people living with MSDs. With an evidence base of over 30 studies conducted in Europe, Fit for Work is currently testing practical solutions to MSDs in several members states (Spain, the UK, Latvia, Portugal, Lithuania). 

The first results of the Early Intervention pilot that ran in Spain clearly indicates that an earlier, more sustained recovery for working age citizens suffering from MSDs can highly contribute towards increased cost savings for the economy, easing the strain on the health care systems and increasing the labour market participation. As featured in the Parliament Magazine (p. 27), the Spanish pilot showed a 50% reduction in permanent work disability (people leaving work completely), a 39% decrease in temporary work disability (people having sick days from work as a result of their condition) and a 40% reduction in sanitary costs. In addition, it highly increased patient satisfaction, whilst the cost-benefit analysis revealed a two-year return of more than €10 for each €1 invested in the programme.

Fit for Work summons DG SANCO not to be oblivious to an innovative solution like Early Intervention, which could benefit not only the Europeans living with MSDs, but also people with other chronic conditions such as cancer, diabetes, cardiovascular and mental health disorders.

>>> Check independent expert opinions about MSDs and Early Intervention featured in a video from the Fit for Work 2013 Summit

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New study reveals intervention that could significantly reduce impact of one million EU workers needlessly off sick each day

Wednesday, October 16th, 2013

An extra one million employees could be at work each day if early interventions were more widely accessible for people with musculoskeletal disorders (MSDs) such as back pain. This is according to a new report from the Fit for Work Europe Coalition, written by The Work Foundation and published today (16 October) at a summit in the European Parliament, Brussels, endorsed by the Lithuanian Presidency of the EU Council.

With many EU member states on track to see 50% of their population diagnosed with an MSD by 2030, the report warns that early treatment for MSDs must be prioritised in order to tackle this growing problem. But it also shows how permanent work disability could fall by 50% if a tried and tested model were to be followed across different countries.

The leading cause of sickness absence across the EU, 44 million workers now have MSDs – including back pain and strains of the neck, shoulder and arms. This costs up to €240bn annually in lost productivity and sickness absence, representing up to 2% of GDP across the EU. The report calls on EU member states to coordinate action between government departments, employers and clinicians to tackle this problem and save billions while transforming the lives of those affected by such devastating conditions.

As our analysis shows, access to early healthcare interventions for workers with MSDs are not being prioritised,” said Professor Stephen Bevan, Founding President of the Coalition – a group representing physicians, patient organisations, economists and researchers promoting policies to improve workforce health. “Thousands are taking unnecessarily long periods away from work or even leaving work permanently when tried and tested tactics could be helping to speed up their recovery and return to work,” he added.

Using data from a two-year trial of a successful early intervention clinic for people with MSDs in Madrid, Spain, the Fit for Work Europe Coalition has developed estimates of the effect of repeating its results across 12 EU member states where comparable data exists.

By assessing and treating 13,000 workers with MSDs after five days of sickness, the Madrid clinic succeeded in reducing temporary work absence by 39% and permanent work disability by 50%. The report explores the implications of these findings on 12 EU member states and estimates how they would affect all 28 EU member states.

Professor Steve Bevan, who is also a director at The Work Foundation continued, “If these results were repeated across the whole of the EU, we estimate that up to one million workers would be available to work each day. This would be a considerable boost to productivity and significantly reduce sick pay bills at a time when member states are under pressure to make savings and increase economic growth. Even if the reduction in absence achieved were 25% rather than 39%, we estimate that in excess of 640,000 extra workers would be available for work each day.

The analysis, led by Professor Juan Jover, shows that if the Madrid results were repeated across Spain, where 26m working days are lost to MSDs each year, over 46,000 Spanish workers would be available for work each day instead of on sick leave. As the table below indicates, the numbers for 11 other EU member states are equally striking. For example, in Germany, the 217 million working days lost each year to MSDs could be reduced by around 480,000 (39%) if the Madrid clinic results were replicated – or by over 300,000 (if a more conservative estimate of 25% were achieved).

Purification Tejeda, a patient suffering from extreme pain from carpal tunnel syndrome, described how she benefited from the support of an early intervention clinic: “I was so scared about the impact it would have on my personal working life. I was given the right diagnosis, treatment and care very quickly and this helped to take away my unbearable pain. Thanks to this clinic, I can go back to work again. Work is so important to me. It makes me feel useful and responsible. I feel alive again.”

The full findings of the research is being presented at a summit  hosted by the Fit for Work Europe Coalition taking place at the European Parliament today (16 October). It will be attended by the Lithuanian Minister for Health of the EU and international delegates from welfare and health government departments, businesses and healthcare organisations.

 Ends

Table showing data from 12 member states (70% of the EU workforce)

As the way patients are referred to early intervention services varies considerably between countries, this data is based on a more cautious estimate scenario of 25% instead of the 39% improvement rate achieved in the Madrid clinic. Nonetheless, the number of lost working days avoided even in this conservative estimate would still be substantial and show the significant impact that wider access to early intervention could have across the EU.   

 

Country Days lost to MSDs each year Number available to work if Madrid results replicated Number available to work with just a 25% reduction
Germany 217m 479,973 307,675
UK 35m 62,045 39,773
Spain 26m 46,091 29,545
Poland 21.7m 38,538 24,704
France 13.4m 23,724 15,208
Austria 7.7m 13,650   8,750
Ireland 7m 12,409   7,955
Finland 5.15m  9,142   5,860
Romania 3.15m  5,594   3,586
Slovenia 2.47m  4,379   2,807
Greece 1.2m  2,472   1,584
Estonia 1.02m  1,815   1,164
       
TOTAL 340.79m  699,832 448,610

Notes to editors

  1. An infographic (attached) is being launched at the 5th Fit for work Europe Summit, Investing in Healthcare: Breaking down the silos in the European Parliament, Brussels on 16 October 2013. This will be available from 14.00hrs CET on 16 October 2013 or from The Work Foundation media team in advance.
  2. Professor Stephen Bevan, Founding President of Fit for Work Europe and a director at The Work Foundation along with Fit for Work Co-presidents, Antonyia Parvanova MEP, Dame Carol Black and Professor Paul Emery are available for interviews, comments and briefings.
  3. Fit for Work Europe is a multi-stakeholder Coalition, driving policy and practice change across the work and health agendas. We aim to deliver more investment in sustainable healthcare by promoting and implementing early intervention practices. Research shows this approach is the most effective way of ensuring people with MSDs (musculoskeletal disorders) can enter and remain in work across the EU and globally.
  4. Fit for Work Europe is a project led by The Work Foundation, supported by AbbVie and GE Healthcare. For more information, please visit, www.fitforworkeurope.eu
  5. The Work Foundation aims to be the leading independent, international authority on work and its future, influencing policy and practice for the benefit of society. The Work Foundation is part of Lancaster University – an alliance that enables both organisations to further enhance their impact.
  6. AbbVie is a global, research-based biopharmaceutical company formed in 2013 following separation from Abbott. The company’s mission is to use its expertise, dedicated people and unique approach to innovation to develop and market advanced therapies that address some of the world’s most complex and serious diseases. In 2013, AbbVie employs approximately 21,000 people worldwide and markets medicines in more than 170 countries. For further information on the company and its people, portfolio and commitments, please visit www.abbvie.co.uk.
  7. GE Healthcare provides transformational medical technologies and services to meet the demand for increased access, enhanced quality and more affordable healthcare around the world.  GE (traded as NYSE: GE) works on things that matter – great people and technologies taking on tough challenges. From medical imaging, software & IT, patient monitoring and diagnostics to drug discovery, biopharmaceutical manufacturing technologies and performance improvement solutions, GE Healthcare helps medical professionals deliver great healthcare to their patients. Please visit www3.gehealthcare.com.

 

Media enquiries:

Ioana Piscociu +44 20 7976 3526  ipiscociu@theworkfoundation.com

OR

Angelo Evangelou +44 207 976 3597  aevangelou@theworkfoundation.com

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