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Vocational Rehabilitation after Acquired Brain Injury: A Swedish Study of Benefits and Costs

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DOI: 10.4236/ojtr.2014.23019    3,278 Downloads   3,956 Views   Citations


Purpose: To examine the benefits from a vocational rehabilitation program for patients suffering from Acquired Brain Injury (ABI) in terms of quality of life, and overall health. In addition, to examine the direct societal costs of healthcare interventions related to vocational rehabilitation and indirect societal costs related to production loss. Method: Identified interventions in 45 patients with ABI who were discharged from a vocational rehabilitation program between 2010 and 2011 were documented, classified and translated into costs. Expenses associated with production loss were calculated by comparing sick leave production loss at first contact with the team, with sick leave production loss at discharge. Health related QoL and overall health, was measured at first contact and at discharge by using the EQ5D. Results: For vocational rehabilitation interventions, mean costs were €6303/individual/month. At first contact with the team, mean production loss was estimated to be €4409/individual/month compared; at discharge to be €2446. QoL ratings increased from first contact to discharge, although estimated health did not change. At discharge, significant correlations were found between QoL ratings and estimated health and the extent of production loss (p < 0.05). Conclusion: Healthcare interventions that help ABI patients resume work are cost effective for society as well as for patients.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Samuelsson, K. , Tropp, M. and Lundqvist, A. (2014) Vocational Rehabilitation after Acquired Brain Injury: A Swedish Study of Benefits and Costs. Open Journal of Therapy and Rehabilitation, 2, 133-145. doi: 10.4236/ojtr.2014.23019.


[1] Ontario Brain Injury Association (2011) What Is Acquired Brain Injury.
[2] (1996) World Health Organization, Geneva.
[3] Cicerone, K., Dahlberg, C., Kalmar, K., Langenbahn, D.M., Malec, J.F., Bergquist, T.F., Felicetti, T., Giacino, J.T., Harley, J.P., Harrington, D.E., Herzog, J., Kneipp, S., Laatsch, L. and Morse, P.A. (2000) Evidence-Based Cognitive Rehabilitation: Recommendations for Clinical Practice. Archives of Physical Medicine and Rehabilitation, 8, 1596-1615.
[4] Cicerone, K., Dahlberg, C., Malec, J.F., Langenbahn, D.M., Felicetti, T., Kneipp, S., Ellmo, W., Kalmar, K., Giacino, J.T., Harley, J.P., Laatsch, L., Morse, P. and Catahese, J. (2005) Evidence-Based Cognitive Rehabilitation: Updated Review of the Literature from 1998 through 2002. Archives of Physical Medicine and Rehabilitation, 86, 1681-1692.
[5] Thurman, D., Alverson, C., Dunn, K., Guerrero, J. and Sniezek, J. (1999) Traumatic Brain Injury in the United States: A Public Health Perspective. Journal of Head Trauma Rehabilitation, 14, 602-615.
[6] Fortune, N. and Wen, X. (1999) The Definition, Incidence and Prevalence of Acquired Brain Injury in Australia. Australian Institute of Health and Welfare, Canberra.
[7] Johansson, B., Saarela, T. and Stenson, S. (2013) Acquired Brain Injury [In Swedish]. hjarnskador/
[8] Eriksson, G., Eriksson, L., Ottander, A., Bexell-Brantefors, K., Lindgren, F. and Morén, L. (2000) The Situation for Persons with Aquired Brain Injury [In Swedish]. County Council, Uppsala.
[9] Consensus National Institute of Health (1999) Rehabilitation of Persons with Traumatic Brain Injury. Journal of the American Medical Association, 10, 974-983.
[10] Lundqvist, A., Grundström, K., Samuelsson, K. and Rönnberg, J. (2010) Computerized Training of Working Memory in a Group of Patients Suffering from Acquired Brain Injury. Brain Injury, 24, 1173-1183.
[11] Durand, M.J. and Loisel, P. (2001) Therapeutic Return to Work: Rehabilitation in Workplace. Work, 17, 57-63.
[12] Wrona, R.M. (2010) Disability and Return to Work Outcomes after Traumatic Brain Injury: Results from the Washington State Industrial Insurance Fund. Disability and Rehabilitation, 32, 650-655.
[13] Sarajuuri, J., Kaipio, M.L., Koskinen, S., Niemelä, M., Servo, A. and Vilkki, J. (2005) Outcome of a Comprehensive Neurorehabilitation Program for Patients with Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation, 86, 2296-2302.
[14] Nishino, A., Sakurai, Y., Tsuji, E., Arai, H., Uenohara, H., Suzuki, S. and Li, J.H. (1999) Resumption of Work after Aneurysmal Subarachnoid Haemorrhage in Middle-Aged Japanese Patients. Journal of Neurosurgery, 90, 59-64.
[15] van Velzen, J., van Bennekom, C., Edelaar, M., Sluiter, J. and Frings-Dresen, M. (2009) How Many People Return to Work after Acquired Brain Injury? A Systematic Review. Brain Injury, 23, 473-488.
[16] Grosswasser, Z., Melamed, S., Agranov, E. and Keren, O. (1999) Return to Work as an Integrated Outcome Measure Following Traumatic Brain Injury. Neuropsychological Rehabilitation, 9, 493-504.
[17] Klonoff, P., Watt, L., Dawson, L., Henderson, S., Gehrels, J.A. and Wethe, J.V. (2006) Psychosocial Outcomes 1-7 Years after Comprehensive Milieu-Oriented Neurorehabilitation: The Role of Pre-Injury Status. Brain Injury, 20, 601-612.
[18] Johnstone, B., Vessel, R., Bounds, T., Hoskins, S. and Sherman, A. (2003) Predictors of Success for State Vocational Rehabilitation Clients with Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation, 84, 161-167.
[19] Turner-Stokes, L., Nair, A., Sedki, I., Disler, P.B. and Wade, D.T. (2005) Multi-Disciplinary Rehabilitation for Acquired Brain Injury in Adults of Working Age. Cochrane Database of Systematic Reviews.
[20] Black, C. (2008) Working for a Healthier Tomorrow. The Stationery Office, London.
[21] SBU-Rapport nr 177/1:159-190.
[22] Drummond, M.F., Sculpher, M.J., Torrance, G.W., O’Brien, B.J. and Stoddart, G.L. (2005) Methods for the Economic Evaluation of Health Care Programmes. 3rd Edition, Oxford University Press, Oxford.
[23] (1999) Socialförsäkringslagen [The Swedish Social Insurance]. 799.
[24] Lundqvist, A., Linnros, H., Orlenius, H. and Samuelsson, K. (2010) Improved Self-Awareness and Coping Strategies for Patients with Acquired Brain Injury—A Group Therapy Programme. Brain Injury, 24, 823-832.
[25] World Health Organization (2001) International Classification of Functioning, Disability and Health: ICF. WHO, Geneva.
[26] Swedish Central Bureau of Statistics.
[27] EQ-5D.
[28] Lezak, M. (2004) Neuropsychological Assessment. Oxford University Press, New York.
[29] Levander, S. (1988) An Automated Psychological Test Battery. IBM-PC Version (APT-PC). Research Reports from the Department of Psychiatry & Behavioral Medicine, University of Trondheim, Trondheim.
[30] Wechsler, D. (1997) Wechsler Adult Intelligence Scale. 3rd Edition, The Psychological Corporation, San Antonio.
[31] Delis, D., Kaplan, E. and Kramer, H. (2001) D-KEFS. Technical Manual. San Antonio TX. The Psychological Corporation, San Antonio.
[32] Loong, J. (1990) Wisconsin Card Sorting Test. Neuropsychological Assessment Software and User’s Manual. Psychological Assessment Resources, Inc., Lutz.
[33] Zigmond, A.S. and Snaith, R.P. (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361-370.
[34] Radford, K., Phillips, J., Drummond, A., Sach, T., Walker, M., Tyerman, A., Haoubi, N. and Jones, T. (2013) Return to Work after Traumatic Brain Injury: Cohort Comparison and Economic Evaluation. Brain Injury, 27, 507-520.
[35] Gollaher, K., High, W., Sherer, M., Bergloff, P., Boake, S., Young, M.E. and Ivanhoe, C. (1998) Prediction of Employment Outcome One to Three Years Following Traumatic Brain Injury (TBI). Brain Injury, 12, 255-263.
[36] Hofgren, C., Esbjörnsson, E. and Sunnerhage, K.S. (2010) Return to Work after Acquired Brain Injury: Facilitators and Hindrances Observed in a Sub-Acute Rehabilitation Setting. Work, 30, 431-439.

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