scholarly journals Development and Initial Validation of a Harmonised Multi-Jurisdiction Work Injury Compensation Database

Author(s):  
Alex Collie ◽  
Michael Di Donato ◽  
Dianne Beck ◽  
Luke R Sheehan

IntroductionNearly one quarter of a million Australian workers experience a work injury annually and make a benefit claim through one of the nation’s eleven workers’ compensation (WC) systems. The total cost to Australian society has most recently been estimated at $61.8 billion or 4.1% of GDP. The disaggregation of legislative responsibility between jurisdictions has contributed to a lack of common data standards, and thus minimal understanding of the efficiency or effectiveness of service provision in the Australian WC sector. Objectives and ApproachThis project developed a new multi-jurisdictional work disability database including detailed information on work disability duration, health and social care service provision. Service level payment data contained in structured WC insurance claims datasets held by five large WC jurisdictions with >60% coverage of the Australian labour force was collected for all cases of work-related low back pain, fractures and limb soft tissue disease over between 2010 and 2015. Database development involved creation and coding of harmonised service-level indicators for individual episodes of healthcare provision and weekly periods of wage replacement. ResultsA total of 253,000 cases and 10.7 million service episodes are included in the database. Initial exploratory analyses focused on the frequency, prevalence, timing, intensity and continuity of General Practitioner (GP) services to each of the injury groups. Regression modelling examined occupational, injury, demographic and jurisdictional factors affecting GP service use outcomes. As anticipated, service patterns varied by injury type, age, gender and occupational group. Significant differences in service use between WC jurisdictions were observed. Conclusion / ImplicationsThis exploratory study demonstrates the feasibility of developing a population-based service level database for monitoring health service delivery to injured Australian workers. Future studies will examine the impact of jurisdictional policy differences on service delivery, and the relationship between service delivery and outcomes such as disability duration.

Author(s):  
Nadia N Khan ◽  
Liane Ioannou ◽  
Charles Pilgrim ◽  
Arul Earnest ◽  
Ashika Maharaj ◽  
...  

IntroductionNearly one quarter of a million Australian workers experience a work injury annually and make a benefit claim through one of the nation’s eleven workers’ compensation (WC) systems. The total cost to Australian society has most recently been estimated at $61.8 billion or 4.1% of GDP. The disaggregation of legislative responsibility between jurisdictions has contributed to a lack of common data standards, and thus minimal understanding of the efficiency or effectiveness of service provision in the Australian WC sector. Objectives and ApproachThis project developed a new multi-jurisdictional work disability database including detailed information on work disability duration, health and social care service provision. Service level payment data contained in structured WC insurance claims datasets held by five large WC jurisdictions with >60% coverage of the Australian labour force was collected for all cases of work-related low back pain, fractures and limb soft tissue disease over between 2010 and 2015. Database development involved creation and coding of harmonised service-level indicators for individual episodes of healthcare provision and weekly periods of wage replacement. ResultsA total of 253,000 cases and 10.7 million service episodes are included in the database. Initial exploratory analyses focused on the frequency, prevalence, timing, intensity and continuity of General Practitioner (GP) services to each of the injury groups. Regression modelling examined occupational, injury, demographic and jurisdictional factors affecting GP service use outcomes. As anticipated, service patterns varied by injury type, age, gender and occupational group. Significant differences in service use between WC jurisdictions were observed. Conclusion / ImplicationsThis exploratory study demonstrates the feasibility of developing a population-based service level database for monitoring health service delivery to injured Australian workers. Future studies will examine the impact of jurisdictional policy differences on service delivery, and the relationship between service delivery and outcomes such as disability duration.


2020 ◽  
Vol 110 (S2) ◽  
pp. S186-S190 ◽  
Author(s):  
Abigail M. Ross ◽  
Lisa de Saxe Zerden

The seminal Consensus Study by the National Academies of Science, Engineering, and Medicine released in September 2019 describes the benefits of integrating health and social care service delivery, underscoring the central role of social determinants of health (SDOH) in health outcomes. Although the report’s focus on the integration of health and social care contributes a much needed perspective to the national discourse on SDOH and offers a useful framework for organizing service delivery activities, the omission of prevention and health promotion throughout the report is a substantial limitation. We call for increased attention to and investment in prevention and health promotion in the proposed 5As framework. We contend that effectively addressing SDOH and improving alignment between health and social systems require reconceptualization of the traditional health care workforce and renewed state and national advocacy efforts. A paradigm shift encompassing a broader “workforce for health” that is well trained in prevention, health promotion, and advocacy is critical to addressing SDOH, improving population health outcomes, and achieving health equity. Given their professional mission, training, expertise, and scope of practice, social workers are well positioned to lead this effort.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e024645 ◽  
Author(s):  
Hanyuying Wang ◽  
Emily Zhao ◽  
Jane Fleming ◽  
Tom Dening ◽  
Kay-Tee Khaw ◽  
...  

ObjectivesThe present study aimed to examine the impact of loneliness on health and social care service use in the oldest old over a 7-year follow-up.DesignProspective study.SettingUK population-based cohort.Participants713 people aged 80 years or older were interviewed at wave 3 of the Cambridge City over-75s Cohort Study. Of these, 665 provided data on loneliness. During 7 years’ follow-up, 480 participants left the study, of which 389 due to death. 162 still in the study answered the loneliness question.Main outcome measureUse of health and social care services, assessed at each wave from wave 3 to wave 5.ResultsAt wave 3, of 665 participants who had data on loneliness, about 60% did not feel lonely, 16% felt slightly lonely and 25% felt lonely. Being slightly lonely at wave 3 was associated with a shorter time since last seeing a general practitioner (β=−0.5, 95% CI: −0.8 to –0.2); when examining the association between time-varying loneliness and health and social care usage, being lonely was associated with three times greater likelihood of having contact with community nurses and using meals on wheels services (community nurse contact: incidence rate ratio (IRR)=3.4, 95% CI: 1.4 to 8.7; meals on wheels service use: IRR=2.5, 95% CI: 1.1 to 5.6). No associations between loneliness and other health and social care services use were found.ConclusionLoneliness was a significant risk factor for certain types of health and social care utilisations, independently of participants’ health conditions, in the oldest old. Study findings have several implications, including the need for awareness-raising and prevention of loneliness to be priorities for public health policy and practice.


2019 ◽  
Author(s):  
Alice Ndwiga

BACKGROUND INTRODUCTION: The Kenyan constitution seeks to guarantee every citizen the right to quality healthcare services. Quite often this delivery is hampered by geographical location, socio-economic statuses among other factors. The country has a high mobile phone penetration rate. Digitalization of the healthcare sector is a vital aspect that contributes to effective delivery of care services. This study set out to assess the impact of mobile technology in closing the gaps within the health care service delivery. The objective of the study was to investigate the impact of mobile phone technology in bridging the gap in healthcare service delivery in Kenya with a focus on Nairobi, Kibera informal settlements. Hypothesis testing using P-value of 0.05 also showed that use of mobile phone technology positively impacted the delivery of healthcare services. OBJECTIVE The objective of the study was to investigate the impact of mobile phone technology in bridging the gap in healthcare service delivery in Kenya with a focus on Nairobi, Kibera informal settlements. Hypothesis testing using P-value of 0.05 also showed that use of mobile phone technology positively impacted the delivery of healthcare services. METHODS The target population were patients visiting Médecins Sans Frontières (MSF) clinic in Kibera informal settlements. A cross-sectional study design was employed. Purposive and simple random sampling method was used to select the study sample of 210 participants and 3 healthcare providers. Data were collected using survey questionnaire that was provider-administered and Data were analyzed using SPSS version. RESULTS The characteristics of the respondents were general (mean age, education level, social economic status) to only patients who visited the clinics for HIV tests and other related services such as going for ARVs. The main findings showed that 66.12% of the respondents (14.29% strongly agreed + 55.24% agreed) that the use of mobile phone technology improved their access to healthcare services. Using chi square, there was a statistical difference due to the positive impact of mobile technology on healthcare delivery (p=0.05). CONCLUSIONS The study findings showed that 66.12% of the respondents agreed that the use of mobile phone technology and SMS improved their access to healthcare services. The results hypothesis also proved that use of mobile phone technology positively impacts the delivery of healthcare services.


2018 ◽  
Vol 28 (5) ◽  
pp. 481-488 ◽  
Author(s):  
A. Crowther ◽  
A. Taylor ◽  
R. Toney ◽  
S. Meddings ◽  
T. Whale ◽  
...  

AbstractAimsRecovery Colleges are opening internationally. The evaluation focus has been on outcomes for Recovery College students who use mental health services. However, benefits may also arise for: staff who attend or co-deliver courses; the mental health and social care service hosting the Recovery College; and wider society. A theory-based change model characterising how Recovery Colleges impact at these higher levels is needed for formal evaluation of their impact, and to inform future Recovery College development. The aim of this study was to develop a stratified theory identifying candidate mechanisms of action and outcomes (impact) for Recovery Colleges at staff, services and societal levels.MethodsInductive thematic analysis of 44 publications identified in a systematised review was supplemented by collaborative analysis involving a lived experience advisory panel to develop a preliminary theoretical framework. This was refined through semi-structured interviews with 33 Recovery College stakeholders (service user students, peer/non-peer trainers, managers, community partners, clinicians) in three sites in England.ResultsCandidate mechanisms of action and outcomes were identified at staff, services and societal levels. At the staff level, experiencing new relationships may change attitudes and associated professional practice. Identified outcomes for staff included: experiencing and valuing co-production; changed perceptions of service users; and increased passion and job motivation. At the services level, Recovery Colleges often develop somewhat separately from their host system, reducing the reach of the college into the host organisation but allowing development of an alternative culture giving experiential learning opportunities to staff around co-production and the role of a peer workforce. At the societal level, partnering with community-based agencies gave other members of the public opportunities for learning alongside people with mental health problems and enabled community agencies to work with people they might not have otherwise. Recovery Colleges also gave opportunities to beneficially impact on community attitudes.ConclusionsThis study is the first to characterise the mechanisms of action and impact of Recovery Colleges on mental health staff, mental health and social care services, and wider society. The findings suggest that a certain distance is needed in the relationship between the Recovery College and its host organisation if a genuine cultural alternative is to be created. Different strategies are needed depending on what level of impact is intended, and this study can inform decision-making about mechanisms to prioritise. Future research into Recovery Colleges should include contextual evaluation of these higher level impacts, and investigate effectiveness and harms.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sharon J. Davenport

PurposeHealth and social care services should demonstrate the quality of their interventions for commissioners, patients and carers, plus it is a requirement for occupational therapists to measure and record outcomes. Use of the “Therapy Outcome Measure” (TOMs) standardised tool was implemented by an occupational therapy adult social care service to demonstrate outcomes from April 2020, following integration to a community NHS Trust.Design/methodology/approachThe aim was to demonstrate occupational therapy outcomes in adult social care through a local audit of the TOMs. The objective was to determine if clients improved following occupational therapy intervention in the four domains of impairment, activity, participation and wellbeing/carer wellbeing. 70 cases were purposively sampled over a 2-month timeframe, extracting data from the local electronic recording system.FindingsOccupational therapy in adult social care clearly makes an impact with their client group and carers. Evidence from the dataset demonstrates clinically significant change, as 93% of clients seen by adult social care occupational therapy staff showed an improvement in at least one TOMs domain during their whole episode of care. 79% of activity scores, 20% of participation scores and 50% of wellbeing scores improved following intervention. 79% of carer wellbeing scores improved following occupational therapy.Research limitations/implicationsThe audit did not collect data on uptake from the separate teams (equipment, housing, STAR and adult social care work) in occupational therapy adult social care. Potential sampling bias occurred as cases with completed scores only were purposively sampled. Sampling was not random which prevented data gathering on uptake of TOMs across the separate teams. Additionally, the audit results can only be applied to the setting from which the data was collected, so has limited external validity.Originality/valueThese novel findings illustrate the valuable and unique impact of occupational therapy in this adult social care setting. The integration of adult social care into an NHS Community Trust has supported the service to measure outcomes, by utilising the same standardised tool in use by allied health professions across the Trust.


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