Abásolo, LydiaCandelas Rodríguez, Gloria Del MarLajas Petisco, Cristina De JesúsVargas Castrillón, EmilioFernández Gutiérrez, BenjamínHernández García, CésarJover Jover, Juan Ángel2025-01-152025-01-152005-09-20Abásolo L, Blanco M, Bachiller J, Candelas G, Collado P, Lajas C, Revenga M, Ricci P, Lázaro P, Aguilar MD, Vargas E, Fernández-Gutiérrez B, Hernández-García C, Carmona L, Jover JA. A health system program to reduce work disability related to musculoskeletal disorders. Ann Intern Med. 2005 Sep 20;143(6):404-14. doi: 10.7326/0003-4819-143-6-200509200-00005.10.7326/0003-4819-143-6-200509200-00005https://hdl.handle.net/20.500.14352/114364Musculoskeletal disorders (MSDs) are a frequent cause of work disability, accounting for productivity losses in industrialized societies equivalent to 1.3% of the U.S. gross national product. Objective: To evaluate whether a population-based clinical program offered to patients with recent-onset work disability caused by MSDs is cost-effective. Design: Randomized, controlled intervention study. The inclusion and follow-up periods each lasted 12 months. Setting: Three health districts in Madrid, Spain. Patients: All patients with MSD-related temporary work disability in 1998 and 1999. Intervention: The control group received standard primary care management, with referral to specialized care if needed. The intervention group received a specific program, administered by rheumatologists, in which care was delivered during regular visits and included 3 main elements: education, protocol-based clinical management, and administrative duties. Measurements: Efficacy variables were 1) days of temporary work disability and 2) number of patients with permanent work disability. All analyses were done on an intention-to-treat basis. Results: 13 077 patients were included in the study, 7805 in the control group and 5272 in the intervention group, generating 16 297 episodes of MSD-related temporary work disability. These episodes were shorter in the intervention group than in the control group (mean, 26 days compared with 41 days; P < 0.001), and the groups had similar numbers of episodes per patient. Fewer patients received long-term disability compensation in the intervention group (n = 38 [0.7%]) than in the control group (n = 99 [1.3%]) (P < 0.005). Direct and indirect costs were lower in the intervention group than in the control group. To save 1 day of temporary work disability, $6.00 had to be invested in the program. Each dollar invested generated a benefit of $11.00. The program's net benefit was in excess of $5 million. Limitations: The study was unblinded. Conclusions: Implementation of the program, offered to the general population, improves short- and long-term work disability outcomes and is cost-effective.engjournal article2767-7664https://doi.org/10.7326/0003-4819-143-6-200509200-0000516172439https://www.acpjournals.org/doi/10.7326/0003-4819-143-6-200509200-00005https://pubmed.ncbi.nlm.nih.gov/16172439/restricted access616.1/.9MedicinaMedicina interna32 Ciencias Médicas3205 Medicina Interna