scholarly journals Data linkage to build detailed return-to-work trajectories for work disability research

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Esther Maas ◽  
Wei Zhang ◽  
Mieke Koehoorn ◽  
Chris McLeod
Keyword(s):  
Health Services ◽  
Return To Work ◽  
Work Disability ◽  
Population Based ◽  
Economic Benefits ◽  
Injured Workers ◽  
Workers Compensation ◽  
Prescription Data ◽  
Cost Benefits ◽  
The Cost

IntroductionMusculoskeletal disorders (MSDs) are the most prevalent chronic condition in Canada, and account for the highest disability costs. Gradual-return-to-work (GRTW) can improve health and labour market outcomes in an aging workforce at risk of MSDs. Linked longitudinal data enables us to generate evidence of GRTW to inform policy needs. Objectives and ApproachThe objective of this study was to investigate the effectiveness and cost-benefits of GRTW for workers with a work-acquired MSD in British Columbia, Canada. We linked workers’ compensation data, health services data, and prescription data from three governing bodies to 1) identify injured workers with an accepted MSD lost-time injury between 2010 and 2015; 2) identify trajectories of RTW states (injury, sickness absence, GRTW, RTW, and non-RTW) and the probability of transitioning between states; and 3) assess the association between workers characteristics and RTW trajectories, and analyze the cost-benefits of GRTW. ResultsFinal results are expected early 2019. To our knowledge, this will be the first study linking workers’ compensation data (in particular detailed RTW data), health services data and prescription data from three different governing bodies for a comprehensive, population-based investigation of work disability experiences over a longitudinal time period and within the Canadian context. Also, using this data for the purpose of assessing the cost-benefits is new, and will help to prioritize prevention resources and strategies to limit the health and economic impact of work-related MSDs on employers, workers’ compensation boards and society. Conclusion/ImplicationsEvaluating the effects of GRTW on work disability is essential to maximize the health and economic benefits for injured workers. The innovation of this project is that is links three population-based databases to capture multiple indicators of health and work status to build RTW trajectories over time.

scholarly journals O2C.2 Does region of residence matter for return-to-work after work-related injury? A comparative analysis of six canadian workers’ compensation jurisdictions

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A16.1-A16
Author(s):  
Robert Macpherson ◽  
Hui Shen ◽  
Mieke Koehoorn ◽  
Benjamin Amick ◽  
Alex Collie ◽  
...  
Keyword(s):  
Return To Work ◽  
Rural Areas ◽  
Urban Areas ◽  
Work Disability ◽  
Injured Workers ◽  
Workers Compensation ◽  
Disability Benefits ◽  
Work Related ◽  
Work Related Injury ◽  
Urban Rural

ObjectivesTo investigate regional differences in return-to-work following work-related injury and whether these differences persist after adjusting for individual characteristics.MethodsWorkers’ compensation claims from six Canadian provinces were used to create comparable cohorts of workers aged 15–80 with a work-related injury resulting in at least one disability day from 2011 to 2015. Workers’ residential postal codes were mapped to Census standard geographic units to categorize workers into six regions representing decreasing urban density and metropolitan influence (ranging from large urban areas of 100,000+people to rural areas of <10 000 people with no metropolitan influence). Cox regression models were used to estimate the effect of urban-rural residence on the likelihood of injured workers transitioning off work disability benefits within one-year post-injury, adjusting for confounders, including provincial compensation jurisdiction. Models were stratified by industry sectors.ResultsThe cohort included 7 46 029 work disability claims, of which the majority resided in large urban areas (69%). Unadjusted models showed that workers residing in smaller urban and rural areas had a lower likelihood of transitioning off work disability benefits compared to those in large urban areas. Urban-rural differences persisted in adjusted models (e.g. HR=0.91 95% CI 0.89, 0.94 for workers in rural areas with no metropolitan influence). Industry-stratified models showed that greater differences existed between urban and rural places of residence for workers in the transportation and construction sectors, and smaller differences for workers in the health care and manufacturing sectors.ConclusionsThe main finding suggests that injured workers in more rural areas face barriers in returning to work and that workers’ compensation resources may need to be allocated to address these regional disparities. Future research will incorporate both individual and regional-level variables in a multilevel model framework to identify the characteristics that are the most important in explaining variability in work disability duration.

scholarly journals Quality evaluation of workers’ compensation hospital in Korea

2014 ◽  
Vol 9 ◽  
Author(s):  
Jong-Uk Won
Keyword(s):  
Health Care ◽  
Occupational Health ◽  
Return To Work ◽  
Hospital Stay ◽  
Evaluation Method ◽  
Length Of Hospital Stay ◽  
Work Rate ◽  
Injured Workers ◽  
Workers Compensation ◽  
Occupational Health Care

Background: The length of hospital stay among occupationally injured workers was too long comparing to national health insurance patients in Korea. Also return-to-work rate was low comparing to other countries. The Korea Workers’ Compensation & Welfare (COMWEL) has tried to upgrade the quality of care workers’ compensation contract hospitals since several years. One of the tries was to evaluate the workers’ compensation contract hospitals. However, many hospitals argued the appropriateness of the hospital evaluation.Objectives: This study was performed to evaluate the appropriateness of the workers’ compensation contract hospital evaluation.Methods: The total number of 500 hospitals was selected to evaluate among about 5,500 contracts hospitals according to their size or the number of occupationally injured patients. The main evaluation items were hospital facilities and equipment, health personnel, including doctors, record keeping, appropriateness of hospital care, outcomes, including return-to-work, length of hospital stay, satisfaction, etc. Multiple logistic regression was performed to evaluate the appropriateness of the results of this hospital evaluation. The dependent variables were return-to-work rate and length of hospital stay and independent variables were severity of injured workers, disability rate, company size, etc.Results: The hospitals were classified three categories according to the evaluation score; high, middle, and low quality. The return-to-work rate of high-quality hospitals was significantly higher (odds ratio 1.81; CI 1.27 – 2.58) than others. However, the length of hospital stay was not different among them.Conclusion: Return-to-work rate is one of the useful indicators for evaluating the occupational health care. Even though these are preliminary results, this evaluation method for the occupational health care hospitals would be appropriate for the purpose. The more specific analysis should be needed.

Injured workers and their return to work

2016 ◽  
Vol 4 (1) ◽  
pp. 2-29 ◽  
Author(s):  
Monica Galizzi ◽  
Roberto Leombruni ◽  
Lia Pacelli ◽  
Antonella Bena
Keyword(s):  
Return To Work ◽  
Job Security ◽  
Injured Workers ◽  
Reduced Form ◽  
Institutional Setting ◽  
Workers Compensation ◽  
High Wage ◽  
Data Set ◽  
Content Type ◽  
Ex Post

Purpose – The purpose of this paper is to study the factors affecting the return to work (RTW) of injured workers in an institutional setting where workers’ earnings are fully compensated during the disability period. Design/methodology/approach – The authors use a unique data set matching employer-employee panel data with Italian workers’ compensation records. The authors estimate survival models accounting for workers’ unobserved heterogeneity. Findings – Workers with higher wage growth, higher relative wages and from firms with better histories of stable employment, RTW sooner. More vulnerable workers – immigrants, females, members of smaller firms – also tend to return sooner. But even when we control for such measures of commitment, status, and job security, high-wage workers RTW sooner. Research limitations/implications – The authors use proxies as measures of commitment and status. The authors study blue-collar workers without finer job qualifications. The authors estimate a reduced form model. Practical implications – In an institutional environment where the immediate cost of workers’ compensation benefits falls largely on firms, employers seem to pressure those workers whose time off is more costly, i.e., high-wage workers. The lack of evidence of ex post moral hazard behavior also demands for a better understanding of the relationship between benefits and RTW. Social implications – Workers who are induced to RTW before full recovery jeopardize their long- term health and employability. Firms that put such pressure on employees might generate social costs that can be particularity high in the case of high productivity workers. Originality/value – The paper offers the first quantitative analysis of an institutional setting where injured workers face 100 percent benefits replacement rate and have job security. This allows focus on other workers’ or employers’ reasons to speed RTW. It is one of very few economics studies on this topic in the European context, providing implications for human resource managers, state regulators, and unions.

scholarly journals Return to work rate rises in the Sunshine State (Queensland, Australia)

2014 ◽  
Vol 9 ◽  
Author(s):  
Sharon Stratford
Keyword(s):  
Return To Work ◽  
Work Rate ◽  
Injured Workers ◽  
Work Outcomes ◽  
Workers Compensation ◽  
Annual Survey ◽  
Work Outcome ◽  
State Records

Measuring return to work outcomes after injury is in itself a challenge for most workers’ compensation schemes. Increasing return to work rates is even more difficult. In Australia, the national return to work measure obtained via an annual survey of injured workers has not risen since its introduction in 1997/98. However, unlike most other Australian jurisdictions, Queensland, Australia's ‘sunshine state’, records return to work outcomes at the end of every time lost claim. More than this, Queensland has increased its overall return to work outcome in recent years from 90% to over 95%. A number of specific strategies were introduced to improve these return to work results. The presentation will outline these strategies which other jurisdictions and countries can hopefully learn from. In addition, WorkCover Queensland, the state's monopoly insurer outside self-insurers, has introduced further return to work measures it successfully uses both internally and externally.

Experiences of Medical Advisors in the Workers' Compensation System in British Columbia

2007 ◽  
Vol 2 (1) ◽  
pp. 18-26
Author(s):  
Lydia Arnold-Smith ◽  
Henry G. Harder
Keyword(s):  
Return To Work ◽  
System Analysis ◽  
Compensation System ◽  
Injured Workers ◽  
Research Report ◽  
Workers Compensation ◽  
Central Theme ◽  
Work Process ◽  
Attending Physicians

AbstractAttending physicians and medical advisors, physicians contracting their services to the Workers' Compensation Board, have key roles in assisting injured workers to return to work. A literature review of the role of the physician in the compensable return to work process reveals a lack of information regarding the experiences of medical advisors. This descriptive phenomenological study was undertaken to explore the lived experiences of four medical advisors in a northern rural service delivery location. The purpose of the research was to gain an understanding of the medical advisors' experiences in the compensable return to work process and in the compensation system. Analysis of the interview data revealed a central theme of commitment to quality medical care for injured workers, along with three major themes and several minor themes subsumed within the major concepts: providing medical opinions — requiring factual information, clarifying the diagnosis, no previous relationship with worker, categories of injuries; working with attending physicians and specialists — building relationships, evidence based treatment plans, role of the attending physician, role of the medical advisor; and, working within the workers' compensation environment — structure and policies, expedited services, and case management/team environment. This research report presents the central theme as the foundation through which the major themes are interconnected. This study does not generalise to all medical advisors, but relays stories that contain the essence of a lived experience.

scholarly journals Step-downs reduce workers’ compensation payments to encourage return to work. Are they effective?

2019 ◽  
Author(s):  
Tyler J Lane ◽  
Luke R Sheehan ◽  
Shannon E Gray ◽  
Dianne Beck ◽  
Alex Collie
Keyword(s):  
Mental Health ◽  
Return To Work ◽  
Combined Effect ◽  
Injured Workers ◽  
Administrative Claims ◽  
Workers Compensation ◽  
Exit Rate ◽  
Policy Objective ◽  
Compensation Systems ◽  
New Findings

AbstractObjectiveTo determine whether step-downs, which cut the rate of compensation paid to injured workers after they have been on benefits for several months, are effective as a return to work incentive.MethodsWe aggregated administrative claims data from seven Australian workers’ compensation systems to calculate weekly scheme exit rates, a proxy for return to work. Jurisdictions were further subdivided into four injury subgroups: fractures, musculoskeletal, mental health, and other trauma. The effect of step-downs on scheme exit was tested using a regression discontinuity design. Results were pooled into meta-analyses to calculate combined effects and the proportion of variance attributable to heterogeneity.ResultsThe combined effect of step-downs was a 0.86 percentage point (95% CI -1.45 to -0.27) reduction in the exit rate, with significant heterogeneity between jurisdictions (I2 = 68%, p = .003). Neither timing nor magnitude of step-downs was a significant moderator of effects. Within injury subgroups, only fractures had a significant combined effect (-0.84, 95% CI -1.61 to -0.07). Sensitivity analysis indicated potential effects within mental health and musculoskeletal conditions as well.ConclusionsThe results suggest some workers’ compensation recipients anticipate step-downs and exit the system early to avoid the reduction in income. However, the effects were small and suggest step-downs have marginal practical significance. We conclude that step-downs are generally ineffective as a return to work policy initiative.Key messages1.What is already known about this subject?A number of workers’ compensation systems around the world reduce payments to injured workers after they have been in the system for several months. In Australia, where each state, territory, and Commonwealth system employs step-downs, the stated policy objective is to increase the rate of return to work through financial incentives. However, there is little empirical evidence to either support or reject this claim.2.What are the new findings?The rate at which claimants exited workers’ compensation systems increased ahead of step-downs taking effect, suggesting an anticipatory effect. However, the effect was relatively small, changing the exit rate by less than a percentage point overall, with substantial heterogeneity between systems.3.How might this impact on policy or clinical practice in the foreseeable future?While statistically significant, the findings suggest that step-downs provide workers’ compensation claimants little incentive to return to work. Policymakers may need to reconsider step-downs as a component of scheme design, or justify them according to their original purpose, which was to save costs.

scholarly journals 229Step-downs reduce workers’ compensation payments to encourage return to work. Are they effective?

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Tyler Lane ◽  
Luke Sheehan ◽  
Shannon Gray ◽  
Alex Collie
Keyword(s):  
Mental Health ◽  
Return To Work ◽  
Injured Workers ◽  
Practical Significance ◽  
Administrative Claims ◽  
Workers Compensation ◽  
Negative Effects ◽  
Compensation Systems ◽  
Meta Analyses ◽  
A Minor

Abstract Background Workers’ compensation systems throughout Australia implement “step-downs,” which cut the amount paid to injured workers after they have received benefits for several months. Though initially introduced to control rising insurance premiums, step-downs are currently justified as an incentive return to work. Whether they have this effect has never been formally tested. Methods Using administrative claims data, we applied a regression discontinuity study design to test whether step-downs affected weekly scheme exit rates, a proxy for return to work, within eight state, territory, and Commonwealth workers’ compensation systems. We also examined effects by injury type (fractures, musculoskeletal, mental health, and other trauma). To derive generalised effects, we combined results using meta-analyses and conducted meta-regressions to determine whether timing or magnitude of step-downs significantly moderated effects. Results Step-downs reduced scheme exit by 0.86 percentage points (95% CI: -1.45, -0.27). Neither timing nor magnitude of step-downs was a significant effect moderator. There were significant effects in fractures (-0.84, 95% CI: -1.61, -0.07) and sensitivity analysis suggested possible effects within mental health and musculoskeletal conditions. Conclusions The negative effects suggest some workers’ compensation recipients anticipate step-downs and return to work early to avoid a reduction in income. However, the effects were small and suggest step-downs have marginal practical significance. We conclude that step-downs are generally ineffective as a return to work policy initiative. Key messages Reducing the amount of compensation paid to injured workers has a minor incentivising effect on their return to work rates.

Managing Work Disability: Why First Return to Work is Not a Measure of Success

ILR Review ◽  
1995 ◽  
Vol 48 (3) ◽  
pp. 452-469 ◽  
Author(s):  
Richard J. Butler ◽  
William G. Johnson ◽  
Marjorie L. Baldwin
Keyword(s):  
Return To Work ◽  
Vocational Rehabilitation ◽  
Work Disability ◽  
Workers Compensation ◽  
Data Set ◽  
Time Period ◽  
Rich Data ◽  
Rate Of Success

Studies of the effectiveness of medical and vocational rehabilitation and the disincentive effects of workers' compensation benefits frequently assume that a return to work signals the end of the limiting effects of injuries. This study is the first to test that assumption empirically. The authors use a rich data set on Ontario workers with permanent partial impairments resulting from injuries that occurred between 1974 and 1987 to show that the effects of injuries on employment are more enduring than previous studies indicate. The rate of successful returns to employment, measured by first return to work, is 85%, but the rate of success evaluated over a longer time period is only 50%.

scholarly journals Does gradually returning to work improve time to sustainable work after a work-acquired musculoskeletal disorder in British Columbia, Canada? A matched cohort effectiveness study

2021 ◽  
pp. oemed-2020-107014
Author(s):  
Esther T Maas ◽  
Mieke Koehoorn ◽  
Christopher B McLeod
Keyword(s):  
Women Workers ◽  
Soft Tissue ◽  
Return To Work ◽  
Work Disability ◽  
Musculoskeletal Disorder ◽  
Soft Tissue Injuries ◽  
Injured Workers ◽  
Effectiveness Study ◽  
Matched Cohort ◽  
Time Loss

ObjectiveThis study investigates if gradual return to work (GRTW) is associated with full sustainable return to work (RTW) for seriously injured workers with a musculoskeletal disorder (MSD), in British Columbia, Canada.MethodsThis is an effectiveness study using a retrospective cohort study design. Accepted workers’ compensation lost-time claims were extracted for workers with an MSD who were on full work disability for at least 30 days, between 2010 and 2015 (n=37 356). Coarsened exact matching yielded a final matched cohort of 12 494 workers who experienced GRTW at any point 30 days post-injury and 12 494 workers without any GRTW. The association between GRTW and sustainable RTW through to end of 12 months was estimated with multivariable quantile regression.ResultsWorkers who were provided with GRTW experienced more time-loss days until sustainable RTW between the 2nd and 5th months after the first time-loss day (<50th quantile of time loss), but less time-loss days until sustainable RTW between the 6th and 12th months of work disability (70th quantile of time loss), with the largest effect for women, workers with soft-tissue injuries and workers in the manufacturing or trades sector (all in the 60th and 70th percentile, after 6–7 months of time loss).ConclusionsFor seriously injured workers with at least 30 days of disability due to a work-acquired MSD, the effect of GRTW becomes apparent at longer disability durations (more than 6 months), with larger beneficial effects for women, workers with soft-tissue injuries and for trade and manufacturing sectors.

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