All well at work? Evaluation of workplace-based early rehabilitation in the Finnish State administration

A comprehensive system for the early rehabilitation of personnel has been d eveloped and practised within the Finnish State administration since 1989. The rehabilitation process can be initiated as soon as the working capacity of a person or work community is threatened but is not yet seriously impai red. Rehabilitation is principally carried out on an outpatient basis along side ordinary work. The aim of the study was to evaluate the outcomes and processes of early re habilitation. The research data comprised several thousands of cases and co nsisted of a cross-sectional and a follow-up survey and a register-based fo llow-up. The surveys showed that during the rehabilitation period the average perfor mance of the participants began to match that of the better-off non-partici pants, especially with respect to their general working capacity, mental we ll-being and occurrence of musculoskeletal problems. The sense of coherence rose in both groups, which can be partly attributed to positive changes in the workplace. In the group process, there also proved to be many factors contributing to achievement of the participants' rehabilitation objectives. The register-based follow-up showed that rehabilitation had a positive eff ect on average longer-term morbidity. In the cases of early retirement, the average retirement age of early rehabilitation participants was considerab ly higher than the average for the State sector as a whole. A system of outpatient early rehabilitation, where the rehabilitation progr amme and the development of working circumstances progress side by side, pr oved to give encouraging results at very moderate cost.