Measurement of Return to Work and Stay at Work Outcomes
Millions of dollars are spent every year on interventions to help injured workers return to work. Treatment success is judged upon operational and functional criteria, centering on the specific behavioral outcomes of return to work and work retention. This chapter discusses the ways in which these outcomes can be measured in patients with musculoskeletal injuries, and other factors that may influence them. Measurements of work status, sickness absence, disability benefits, recurrence of illness or injury, work ability, and productivity are compared. In addition, examination of the impact of social insurance programs and entitlements demonstrates that the incentives and disincentives for return to work provided by the socioeconomic structure of the disability and rehabilitation system should be considered when choosing an appropriate measure of return to work. Finally, measures of return to work in clinical populations other than musculoskeletal injuries are discussed; best measures of return to work vary with the population being studied. Ultimately, it is important that health professionals accept the need to continue to define and document behavioral outcomes in their attempts to return injured or medically ill workers back to employability and functionality.