2016-01-01 12:00 - Messages

Length of Disability and Medical Costs in Low Back Pain

Do State Workers' Compensation Policies Make a Difference?
Objective: The aim of the study was to examine the impact of state workers' compensation (WC) policies regarding wage replacement and medical benefits on medical costs and length of disability (LOD) in workers with low back pain (LBP).
Methods: Retrospective cohort analysis of LBP claims from 49 states (n?=?59,360) filed between 2002 and 2008, extracted from a large WC administrative database.
Results: Longer retroactive periods and state WC laws allowing treating provider choice were associated with higher medical costs and longer LOD. Limiting the option to change providers and having a fee schedule were associated with longer LOD, except that allowing a one-time treating provider change was associated with lower medical costs and shorter LOD.
Conclusions: WC policies about wage replacement and medical treatment appear to be associated with WC LBP outcomes, and might represent opportunities to improve LOD and reduce medical costs in occupational LBP.

Source: Shraim, Mujahed; Cifuentes, Manuel; Willetts, Joanna L.; Marucci-Wellman, Helen R.; Pransky, Glenn. Journal of Occupational & Environmental Medicine: December 2015, Volume 57, Issue 12, p. 1275-1283.

Is Early Prescribing of Opioid and Psychotropic Medications Associated With Delayed Return to Work and Increased Final Workers’ Compensation Cost?

Objective: To explore the association between the initial 60 days of prescriptions for psychotropic medications and final workers' compensation claim outcomes.
Methods: A cohort of 11,394 claimants involved in lost time injuries between 1999 and 2002 were followed through December 31, 2009. Logistic regressions and Cox Proportional Hazard Models were used in the analysis.
Results: The initial 60 days of prescriptions for psychotropic medications were significantly associated with a final claim cost at least $100,000. Odds ratios were 1.88 for short-acting opioids, 2.14 for hypnotics, antianxiety agents, or antidepressants, and 3.91 for long-acting opioids, respectively. Significant associations were also found between decreased time lost from work and decreased claim closures during the study period.
Conclusions: Early prescription of opioids and other psychotropic drugs may be useful predictors of high claim costs and time lost from work.

Source: Tao, Xuguang (Grant), Lavin, Robert A.; Yuspeh, Larry; Weaver, Virginia M.; Bernacki, Edward J. Journal of Occupational & Environmental Medicine: December 2015, Volume 57, Issue 12, p. 1315-1318.

Work participation and health-related characteristics of sickness absence beneficiaries with multiple somatic symptoms

Objectives: The primary aim was to study whether high levels of multiple symptoms influenced sick-listed individuals' employment status or desire to return to work (RTW) and whether this was associated with social relations at work.
Study design: A cross-sectional study nested in a clinical trial.
Methods: In 2011–2012, 736 (34%) of 2172 sick-listed individuals completed a posted questionnaire and were included. Main outcome was self-reported employment status. The Symptom Check List (SCL-SOM)'s sum score (0–48) was categorized in high (>18) and low (≤18) levels. Previous employment, sick-listing, and use of health care were register-data. Multivariate logistic regression analyses with adjustments were performed.
Results: Beneficiarie with high SCL-SOM score (n = 218, 33%) reported poorer health, job satisfaction, a lower desire to RTW and more problems with supervisors. The risk of being unemployed was higher for this group than for those with a low score. Adjusting for general health reduced the association between symptoms and unemployment, whereas problems with social relations only affected it marginally.
Conclusions: Sick-listed individuals reporting high levels of symptoms were more often unemployed and less frequently desired to RTW than those with few symptoms. The association could not be explained by problems with social relations at work.

Source: Momsen AH, Nielsen CV, Nielsen MB, et al. Public Health, 2015.

Programme de prise de décision entre l'ergothérapeute et le travailleur ayant une incapacité due à un trouble musculosquelettique persistant

Les travailleurs et les autres acteurs qui prennent des décisions en matière d'interventions de retour au travail ont souvent des intérêts et des buts différents. Le processus de prise de décision partagée (PDP) est une approche centrée sur la personne qui permet d'agir sur les écarts entre les travailleurs et les autres acteurs par rapport au but et au plan d'action à mettre de l'avant. À notre connaissance, un programme de PDP n'avait jamais été spécifiquement contextualisé en réadaptation au travail.

Source: http://www.irsst.qc.ca/publications-et-outils/publication/i/100853/

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