Työterveystoiminnan vaikuttavuus ja sen indikaattorit (Effectiveness and Indicators of Occupational Health Collaboration) was a project co-ordinated by the Ministry of Social Affairs and Health and funded by the European Social Fund (2015 – 2018). The project coordinator was the University of Tampere, with a consortium consisting of the Finnish Institute of Occupational Health, the University of Eastern Finland, and two private and public occupational health service providers, Pihlajalinna Työterveys and Työterveys Wellamo. Here we report the results of the first part of the project that was implemented by the University of Tampere: Työterveyshuollon sairaanhoidon kehittäminen varhaisen työkyvyn tukemiseksi (Developing Occupational Health Primary Care to Support Work Ability). This sub-project focused on the functions of occupational health (OH) primary care that can support occupational health services’ (OHS) legislated preventive functions.
First, we examined high rates of OHS use and the characteristics and determinants of frequent attenders of OHS primary care. The findings indicated that frequent attendance in OH primary care is associated with female gender and working in medium and large companies. Diagnoses of the musculoskeletal system and mental and behavioral disorders are accentuated in this context (ref. Reho Tiia, Atkins Salla, Talola Nina, Viljamaa Mervi, Sumanen Markku, Uitti Jukka (2018). Frequent attenders in occupational health primary care: A cross-sectional study. Scandinavian Journal of Public Health. https://doi.org/10.1177/1403494818777436).
We also examined OH collaborative negotiations, which is a unique function the Finnish OHS. An OH collaborative negotiation is a confidential meeting between the employee, employer and OH physician where work and work modifications are discussed when an employee cannot perform their duties as well as previously. The OH collaborative negotiations were held mainly for employees who had sickness absences prior to the negotiation, which were mostly due to musculoskeletal and mental disorders. Concrete actions to modify work were agreed upon in the negotiations. Working hours were modified for every fourth employee and job descriptions for every third employee. Data analysis indicated that sickness absence episodes and lengths decreased after the negotiation. The English summary is available here https://www.laakarilehti.fi/tieteessa/alkuperaistutkimukset/tyoterveysneuvottelu-tyossa-jatkamisen-tukena-ndash-kuvaileva-tutkimus/
The main outcome of the project was the development, implementation and evaluation of an intervention to OH units, to assess a primary care visit’s cause or diagnoses’ connection to the client’s work, and for estimation of future disability pension. We implemented the intervention using a randomized controlled trial design, with 11 intervention primary health care services acting as intervention sites and 11 as control sites. All doctors and nurses or other OH professionals who were part of the intervention units took part in training provided by Pihlajalinna Työterveys. After the training, a change in how visits were recorded onto electronic patient registers was implemented at all stations. The trial is explained in more detail here (ref. Atkins Salla, Ojajärvi Ulla, Talola Nina, Viljamaa Mervi, Nevalainen Jaakko, Uitti Jukka (2017). Impact of improved recording of work-relatedness in primary care visits at occupational health services on sickness absences: study protocol for a randomised controlled trial. Trials 18, 352).