A Systematic Review of Disability Management Interventions with Economic Evaluations
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INTRODUCTION: We present the results of a systematic literature review of disability management interventions to answer the question: "what is the credible evidence that incremental investment in disability management interventions is worth undertaking?" METHODS: We identified studies through searches in journal databases and requests to content experts. After assessing the quality of studies that met content requirements, we employed a best-evidence synthesis approach. Studies were stratified across several dimensions for evidence synthesis, with industry as the core stratification criterion. RESULTS: We identified 17 disability management interventions with economic analyses, of which eight were of high or medium quality. We found strong evidence supporting the economic merits of multi-sector disability management interventions, but could not make a positive statement about the remaining five industry clusters with studies. For stratification by intervention components, we found moderate evidence for interventions that included an education component, moderate evidence for those with physiotherapy, limited evidence for those with a behavioural component, and moderate evidence for those with a work/vocational rehabilitation component. For stratification by intervention features, we found moderate evidence for interventions that included a work accommodation offer, contact between health care provider and workplace, early contact with worker by workplace, ergonomic work site visits, and interventions with a return-to-work coordinator. CONCLUSIONS: We found credible evidence supporting the financial benefits of disability management interventions for one industry cluster and several intervention components and features.
