Telephone Aftercare by Social Services to Improve Return to Work after Medical Rehabilitation

Abstract

Aim Many patients are discharged from the rehabilitation clinic with a restored working ability, but are often unemployed or there is a mismatch between their skills and the job requirements. Those patients often feel to be left alone with their problems regarding their adequate occupational reintegration and wish to be supported over the course of stationary rehabilitation in terms of socio-legal and social-medical issues. The randomized controlled trial investigated if a 12 month telephone aftercare conducted by staff of the social service has a positive influence on occupational reintegration. Method Patients with severe limitations of work-related functioning were recruited in one rehabilitation center and randomized at the end of rehabilitation. The intervention group (N=171) received a telephone aftercare for 12 month by staff of the social service, the control group (N=162) received the standard aftercare recommendation. The risk of an unsuccessful occupational reintegration was operationalized by means of 3 items, which where summed up to a risk index. The evaluation of the aftercare was conducted by written survey on 3 measurement points. Results Overall 333 patients were included in the study. 45% (N=152) of the sample were female, the mean age was 50 years. 12 month after rehabilitation 71% (N=120) of patients from the intervention group stated to be employed. In the control group the proportion amounts to 68% (N=110; p=0.074, CI -0.0718; 0.1252). The control group has a significant higher risk constellation according to the risk score for occupational reintegration as the intervention group. Conclusion The risk score shows significant advantages for patients in the intervention group. The risk of a non-successful reintegration 12 month after rehabilitation was significant lower in the intervention group. All further occupational and health related outcomes indicate only moderate differences. These should be considered against the background of the low-threshold intervention. The telephone aftercare by staff of the social service was rated as very helpful by most of the patients in the intervention group.