Relation between indicators for quality of occupational rehabilitation of employees with low back pain

Objectives-To assess if the implementation of guidelines for occupational r ehabilitation of patients with low back pain by means of process variables- a set of objective criteria for technical performance and continuity of car e-led to a better outcome in clinical and return to work variables. Methods-The study group consisted of 59 patients with at least 10 days of s ick leave because of low back pain. Univariate analyses as well as multiple logistic regression and Cox's regression analyses were performed to assess the relation between quality of care and outcome. Results-Process indicators for technical competence, continuity of care, an d total performance were all significantly related to satisfaction of emplo yees. Continuity of care and total performance were significantly related t o working status at 3 months, and time to return to work. None of the proce ss indicators was related to pain or disability after 3 months follow up. S atisfaction was not related to any of the other outcome variables. This ind icates that if guidelines for occupational rehabilitation are met, outcome is better. Conclusion-Quality of the process of care was related to outcome. Intervent ions of occupational physicians need improvement in the areas of continuity of care and communication with treating physicians. The effectiveness of a n improved intervention should be studied in a subsequent randomised clinic al trial.