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Promoting occupational health interventions in early return to work by implementing financial subsidies: A Swedish case study
Linkoping Univ, Natl Ctr Work & Rehabil, Dept Med & Hlth Sci, S-58183 Linkoping, Sweden.
Karolinska Inst, Inst Environm Med, Unit Occupat Med, S-10401 Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Karolinska Inst, Inst Environm Med, Unit Occupat Med, S-10401 Stockholm, Sweden.
Linkoping Univ, Natl Ctr Work & Rehabil, Dept Med & Hlth Sci, S-58183 Linkoping, Sweden;Linkoping Univ, Helix Vinn Excellence Ctr, S-58183 Linkoping, Sweden.
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2013 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, 310Article in journal (Refereed) Published
Abstract [en]

Background: In 2010, the Swedish government introduced a system of subsidies for occupational health (OH) service interventions, as a part in a general policy promoting early return to work. The aim of this study was to analyse the implementation of these subsidies, regarding how they were used and perceived. Methods: The study was carried out using a mixed-methods approach, and comprises material from six sub-studies: a register study of the use of the subsidies, one survey to OH service providers, one survey to employers, one document analysis of the documentation from interventions, interviews with stakeholders, and case interviews with actors involved in coordinated interventions. Results: The subsidized services were generally perceived as positive but were modestly used. The most extensive subsidy - for coordinated interventions - was rarely used. Employers and OH service providers reported few or no effects on services and contracts. OH service providers explained the modest use in terms of already having less bureaucratic routines in place, where applying for subsidies would involve additional costs. Information about the subsidies was primarily communicated to OH service providers, while employers were not informed. Conclusions: The study highlights the complexity of promoting interventions through financial incentives, since their implementation requires that they are perceived by the stakeholders involved as purposeful, manageable and cost-effective. There are inherent political challenges in influencing stakeholders who act on a free market, in that the impact of policies may be limited, unless they are enforced by law.

Place, publisher, year, edition, pages
2013. Vol. 13, 310
Keyword [en]
Occupational health; Return to work; Implementation; Sweden; Subsidies; Employers
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URN: urn:nbn:se:uu:diva-247648DOI: 0.1186/1471-2458-13-310ISI: 000318630700001PubMedID: 23566064OAI: oai:DiVA.org:uu-247648DiVA: diva2:797137
Swedish National Board of Health and WelfarePublic Health Agency of Sweden
Available from: 2015-03-23 Created: 2015-03-23 Last updated: 2016-07-20

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