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Purpose <p>This study compared return-to-work (RTW) outcomes among Norwegian patients with musculoskeletal or common mental disorders participating in a 4-week inpatient or 3-month outpatient occupational rehabilitation program, examining associations between program type, pre-intervention sick-leave duration, and RTW.</p> Methods <p>An observational cohort (<i>n</i> = 857) was categorized into five pre-intervention benefit groups, including Group 1 (partial benefits for ≥ 6&#xa0;weeks) and Group 2 (90–100% benefits for 6&#xa0;weeks through 5&#xa0;months). Primary outcome was time to stable RTW (first month without sickness benefits); secondary outcome was cumulative work participation over 24&#xa0;months.</p> Results <p>RTW hazard varied by group and time. During the first 3&#xa0;months, outpatients in Group 1 had a threefold higher hazard of stable RTW than inpatients (HR = 3.61, <i>p</i> = .03). Between 3 and 10&#xa0;months, the pattern reversed, favoring inpatients (outpatient HR = 0.68, <i>p</i> = .01). After 10&#xa0;months, outpatients again had higher RTW hazards, significant only in Group 1. In Group 2, no outpatients achieved RTW during the first 3&#xa0;months; furthermore, between 3 and 10&#xa0;months, inpatients had a significantly higher RTW hazard (outpatient HR = 0.38, <i>p</i> = .02). Median months worked over 24&#xa0;months was 18.1 for outpatients vs. 12.8 for inpatients in Group 1 (<i>p</i> = .08), and 0.6 vs. 5.3 in Group 2 (<i>p</i> = .04).</p> Conclusion <p>Pre-intervention sick-leave duration strongly influences RTW. Program effectiveness is time- and subgroup dependent. Patients with remaining work attachment (partial benefits) may benefit more from outpatient care, while those on full-time benefits for moderate durations benefit more from intensive inpatient programs, suggesting a need for stratified allocation. <i>Trial registration:</i> Current controlled trials <a href="https://doi.org/10.1186/ISRCTN12033424">https://doi.org/10.1186/ISRCTN12033424</a>, 15.10.2014, retrospectively registered.</p>

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Inpatient or Outpatient Occupational Rehabilitation – What Works Best for Whom? A Non-randomized Clinical Trial

  • 期刊论文

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  • 发表日期：

    2026年1月16日

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  • Monica Eftedal,
  • Chris Jensen

摘要

Purpose

This study compared return-to-work (RTW) outcomes among Norwegian patients with musculoskeletal or common mental disorders participating in a 4-week inpatient or 3-month outpatient occupational rehabilitation program, examining associations between program type, pre-intervention sick-leave duration, and RTW.

Methods

An observational cohort (n = 857) was categorized into five pre-intervention benefit groups, including Group 1 (partial benefits for ≥ 6 weeks) and Group 2 (90–100% benefits for 6 weeks through 5 months). Primary outcome was time to stable RTW (first month without sickness benefits); secondary outcome was cumulative work participation over 24 months.

Results

RTW hazard varied by group and time. During the first 3 months, outpatients in Group 1 had a threefold higher hazard of stable RTW than inpatients (HR = 3.61, p = .03). Between 3 and 10 months, the pattern reversed, favoring inpatients (outpatient HR = 0.68, p = .01). After 10 months, outpatients again had higher RTW hazards, significant only in Group 1. In Group 2, no outpatients achieved RTW during the first 3 months; furthermore, between 3 and 10 months, inpatients had a significantly higher RTW hazard (outpatient HR = 0.38, p = .02). Median months worked over 24 months was 18.1 for outpatients vs. 12.8 for inpatients in Group 1 (p = .08), and 0.6 vs. 5.3 in Group 2 (p = .04).

Conclusion

Pre-intervention sick-leave duration strongly influences RTW. Program effectiveness is time- and subgroup dependent. Patients with remaining work attachment (partial benefits) may benefit more from outpatient care, while those on full-time benefits for moderate durations benefit more from intensive inpatient programs, suggesting a need for stratified allocation. Trial registration: Current controlled trials https://doi.org/10.1186/ISRCTN12033424, 15.10.2014, retrospectively registered.