Abstract

BackgroundIn 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.MethodsThe 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.ResultsThe 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.ConclusionsThe 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.

Highlights

  • 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 employer survey showed that only 1 out of 10 employers reported that their OH service provider had applied for subsidies

  • Those employers who reported that their OH service provider had applied for subsidies were more often larger companies

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Summary

Introduction

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. A large number of studies have emphasized the need for workplace-based interventions for promoting early return to work (RTW) [1,2,3,4,5,6,7]. Swedish employers finance the first two weeks of Another factor that may influence RTW processes is the availability of occupational health (OH) services. In the USA, OH is typically used either in connection with workers’ compensation laws to provide medical services for workers with occupational injuries or illnesses, or to provide general medical services aimed at workplace safety and overall worker health [16]. OH service professionals may be involved in the rehabilitation process if the employer chooses to consult them

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