Improving the effectiveness of sickness benefit case management through a public-private partnership A difference-in-difference analysis in eighteen Danish municipalitiesReport as inadecuate




Improving the effectiveness of sickness benefit case management through a public-private partnership A difference-in-difference analysis in eighteen Danish municipalities - Download this document for free, or read online. Document in PDF available to download.

BMC Public Health

, 17:329

Health policies, systems and management in high-income countries

Abstract

BackgroundThe aim of this study was to investigate whether a multidimensional public-private partnership intervention, focussing on improving the quality and efficiency of sickness benefit case management, reduced the sickness benefit duration and the duration until self-support.

MethodsWe used a difference-in-difference DID design with six intervention municipalities and 12 matched control municipalities in Denmark. The study sample comprised 282,103 sickness benefit spells exceeding four weeks. The intervention group with 110,291 spells received the intervention, and the control group with 171,812 spells received ordinary sickness benefit case management. Using register data, we fitted Cox proportional hazard ratio models, estimating hazard ratios HR and confidence intervals CI.

ResultsWe found no joint effect of the intervention on the sickness benefit duration HR 1.02, CI 0.97–1.07 or the duration until self-support HR 0.99, CI 0.96–1.02. The effect varied among the six municipalities, with sickness benefit HRs ranging from 0.96 CI 0.93–1.00 to 1.13 CI 1.08–1.18 and self-support HRs ranging from 0.91 CI 0.82–1.00 to 1.11 CI 1.06–1.17.

ConclusionsCompared to receiving ordinary sickness benefit management the intervention had on average no effect on the sickness benefit duration or duration until self-support. However, the effect varied considerably among the six municipalities possibly due to differences in the implementation or the complexity of the intervention.

KeywordsDenmark Effect evaluation Hazard rate model RTW Sickness benefit duration Sick leave Work resumption AbbreviationsCI Confidence intervals

DID Difference-in-difference

DREAM ‘Danish Register for Evaluation of Marginalisation’

Falck Falck Health Care

GP General practitioner

HR Hazard ratio

OSBM Ordinary sickness benefit management

RCT Randomised controlled trial

RTW Return-to-work

SE Standard error

SIO Social insurance officer

TVC Time varying covariate

VCE Stata’s robust-clustered SE option

Electronic supplementary materialThe online version of this article doi:10.1186-s12889-017-4236-5 contains supplementary material, which is available to authorized users.





Author: Malene Rode Larsen - Birgit Aust - Jan Høgelund

Source: https://link.springer.com/



DOWNLOAD PDF




Related documents