Abstract
Introduction
Burn survivors experience barriers to returning to work. For those who do return to work, little is known regarding whether they achieve pre-injury productivity (i.e., equivalent or gain in income compared to pre-injury income). Identifying patients at risk of not achieving pre-injury productivity is important for targeting services that support this population.
Methods
We extracted occupational and income data through 24 months post-injury from the multi-center, longitudinal Burn Model System National Database. Annual income was reported in six groups: <$25k, $25k-50k, $50k-99k, $100k-149k, $150k-199k, $>199k. Participants were classified by change in income at each follow up (i.e., gain, loss, equivalent). Explanatory variables included demographics, injury characteristics, insurance payer, employment status, and job type. Multi-level, multi-variable logistic regression was used to model return to productivity.
Results
453 participants provided complete income data at discharge and follow up. Of the 302 participants employed pre-injury, 180 (60%) returned to work within 24 months post-injury. Less than half (138) returned to productivity (46% of participants employed pre-injury; 77% of those who returned to work). Characteristics associated with return to productivity included older age (median 46.9 vs 45.9 years, OR 1.03, p=0.006), Hispanic ethnicity (24% vs 11%, OR 1.80, p=0.041), burn size >20% TBSA (33.7% vs 33.0%, OR 2.09, p=0.045), and post-injury employment (54% vs 26%, OR 3.41, p<0.001).
Conclusion
More than half of employed people living with burn injury experienced loss in productivity within 24 months post-injury. Even if they return to work, people living with burn injuries face challenges returning to productivity and may benefit from vocational rehabilitation and/or financial assistance.
Mortality prognostication scores do not predict long-term, health-related quality of life after burn: A burn model system national database study