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  1. Long-term economic effects of team-based clinical case management of patients with chronic minor disease and long-term absence from working life.

    Article - En anglais


    To examine the socio-economic effects of team-based clinical case management of patients with chronic minor disease bound for early retirement.


    Marginal analysis of programme costs and benefits to society compared with no-programme baseline of costs occurring in society due to productivity loss.

    Prospective patient data collection on admission, discharge, and at one year and five years after discharge to determine programme effectiveness.


    Out-patient clinic at the department of social medicine in tertiary care hospital.


    239 patients with minor disease and long-term vocational absence consecutively admitted to the study.

    At the one-year evaluation, 17 patients had been readmitted to the team, 7 could not be found, 6 declined the interview and 2 were deceased.

    At the five-year evaluation of 49 patients who were active after one year, one was deceased and 10 were unable to be found.

    Main outcome measures 

    Vocational activity.

    Programme costs.

    Benefits to society measured by decrease in indirect costs.


    The one-year vocational rehabilitation rate from the program was 20.5% and the five-year rehabilitation rate was 11.3%. The total discounted cost for case management of the 239 patients was 7.6 MSEK (£600,000).

    The decrease in the indirect costs to society from the 28 patients found active after five years was 35.1 MSEK (£2,500,000).

    The net present value of the programme at the 1991 price level was 27.5 MSEK (£2,365,000). (...)

    Mots-clés Pascal : Maladie, Bénin, Afrique, Chronique, Homme, Impact socioéconomique, Coût social, Retraite, Précoce, Soin intégré, Absentéisme, Long terme, Milieu professionnel, Médecine sociale, Analyse avantage coût, Réadaptation professionnelle, Economie santé, Suède, Europe, Programme sanitaire, Réhabilitation

    Mots-clés Pascal anglais : Disease, Benin, Africa, Chronic, Human, Socioeconomical impact, Social cost, Retirement, Early, Managed care, Absenteeism, Long term, Occupational environment, Social medicine, Cost benefit analysis, Vocational rehabilitation, Health economy, Sweden, Europe, Sanitary program, Rehabilitation

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0051404

    Code Inist : 002B30A01C. Création : 14/05/1998.