Evaluation of the economic cost of occupational accidents and occupational diseases on the basis of occupational rehabilitation and determination of service components for Turkey

Occupational accidents and occupational diseases lead to changes in the existing labour force and cause permanent incapacity for work and disability. This situation hinders sustainable employment, and these breaks from employment cause social exclusion. Occupational rehabilitation is a method that rehabilitates the employee with appropriate methods and provides a return to the appropriate job and thus includes arguments to minimise social exclusion. In our country, occupational rehabilitation is not a method that is applied after occupational accidents and occupational diseases. In the research conducted within the scope of the thesis study, occupational rehabilitation service was analysed in terms of cost-benefit according to 2 alternative scenarios. When all alternatives were analysed according to the current situation, Alternative 1 scenario provided a 55.2% decrease in total cost; Alternative 2 scenario provided a 60.3% decrease in total cost. Alternative 2 scenario provided an increase of 4.3% in the benefit compared to Alternative 1 scenario. According to these results, occupational rehabilitation and return to work practices are economically cost-effective. Service components were determined according to the criteria of relevance, human orientation and cost by using AHP method, one of the multi-criteria decision making methods. Accordingly, the occupational rehabilitation service appropriate for Turkey should be applied primarily after 'occupational accidents and occupational diseases'. In occupational rehabilitation, the service provider should be primarily the Ministry of Health and the 'insurance system financed by the employee-employer-state' should be adopted in the financing of the processes. The service should be designed as 'occupational rehabilitation service as a part of health service', the central structuring of the service should primarily be in the form of 'private occupational rehabilitation centres in certain provinces in Turkey' and the service should primarily include job suitability assessments. The final decision on return to work in occupational rehabilitation should be made by a 'commission that can report on fitness for work', and the commission should primarily include the case manager in charge of return to work, representatives of the Ministry of Health, relevant units of the SSI and İŞKUR. The case manager who can work in the return to work process should be defined as a separate field of expertise. The most important functions of the case manager should be to communicate with the employee after the case, to collect information about the case, to share relevant information with the parties, to provide coordination in occupational rehabilitation stages, to provide the necessary documentation for return to work, to communicate with the employee, to prepare an individual action plan specific to the case, to work in cooperation with all relevant parties and actors. The case manager should be appointed by a separate organisation or board responsible for case management. The case manager should contact the employee within 3 working days of the occupational accident/injury and illness detection, primarily upon notification of the employer or health institution. The case management process should be continued 'until return to work'. In this study, multi-criteria decision-making technique was used for the first time in the selection of service components in occupational rehabilitation. The implementation of the occupational rehabilitation service, which is shown to be a cost-effective method and whose components are included, by giving it a legal status by the legislator is very important for the development of human-oriented OHS in our country. The current research is novel because it is the first research for our country. Forcasting whether this service will be cost-effective in the future will make a significant contribution to the literature in terms of supporting effective policy development.