Effects of Vocational Rehabilitation on the Use of Health Care Services in Finland: A Propensity Score Analysis.

Vocational rehabilitation may affect the frequency of health care use by improving the access or reducing the need for health care. We examined whether participation in rehabilitation effects the healthcare services use. Register-based data was utilized on all individuals aged 15-60 living in the city of Oulu, Finland, who started vocational rehabilitation in 2014-2015 (N = 784). We examined the use of outpatient health care services from 1.5 years before to 1.5 years after the start of rehabilitation and 1.5 years after the end of rehabilitation, and compared it to the propensity score matched controls. Rehabilitees had on average 1.5 visits to outpatient health care services in the 6th quarter before the start of rehabilitation. In the 4th quarter before the start of rehabilitation, that number increased to 1.8. After the rehabilitation period, the quarterly number of visits returned to the same level as at the beginning of the follow-up. The biggest changes were in the use of occupational health services. Compared to the propensity score matched controls, vocational rehabilitation did not appear to affect the use of health care services. Vocational rehabilitation seems to replace need for other services but not to affect the need to receive treatment for the underlying disease.