Effectiveness of a Reintegration & Rehabilitation intervention for claimants with long-term disability

The purpose of the R&R study is to evaluate the effectiveness and cost-effectiveness of a combined reintegration and rehabilitation program aimed at improving functioning and return to work for Dutch claimants receiving disability benefits due to long-term reduced earning capacity.

Claimants who receive a treatment in a rehabilitation centre in addition to the regular re-integration support by the Dutch Social Security Institute (SSI) are more likely to return to work compared to claimants who receive regular re-integration support by the Dutch SSI.

Baseline and 6 and 12 months after baseline measurement.

The intervention is an outpatient multidisciplinary treatment in a rehabilitation center. The intervention is divided into two parts: 1. a diagnostic Quick Scan; 2. a multidisciplinary rehabilitation. The aims of the Quick Scan are to identify obstacles for functioning and return to work, assess whether these obstacles are modifiable and what is needed to remove these obstacles. It takes approximately four hours and during this time the participant visits a rehabilitation physician, a psychologist and a physiotherapist (the Quick Scan team). The Quick Scan has two possible outcomes: 1. the Quick Scan team concludes that a multidisciplinary rehabilitation treatment can be beneficial for the participant. The participant will then be invited to participate in this treatment; 2. the Quick Scan team concludes that a multidisciplinary treatment is not the best way to benefit the participant. The participant will stay in the intervention group, but will not receive the multidisciplinary rehabilitation.

The multidisciplinary rehabilitation is expected to have an average duration of three months and aims at removing obstacles for return to work and improving functioning. Depending on the results of the Quick Scan, this could involve improving physical fitness, dealing with medication, exacerbation management, and removal of relevant psychosocial barriers, for example attitude, expectations, fear avoidance, coping, depression and perceived social support. The multidisciplinary team consists of different professionals, based on the main diagnosis and needs of the participant. Examples are a dietician, a physiotherapist, a psychotherapist and a social worker. Depending on the main diagnosis, the rehabilitation team will be led by a rehabilitation physician, cardiologist or pulmonologist.

In addition to the rehabilitation treatment all participants also receive the regular re-integration support by the Dutch SSI.