Innovations in Occupational Health Care Delivery Can Prevent Entry into Permanent Disability

8-Year Follow-up of the Washington State Centers for Occupational Health and Education

Datos Bibliográficos

ID9101593
AutoresThomas M Wickizer (The Ohio State University, autor de correspondencia), Gary M Franklin (0000-0002-1355-4091, Departments of Environmental and Occupational Health Sciences, Neurology and Health Services, University of Washington, Seattle), Deborah Fulton-Kehoe (University of Washington), Deborah Fulton‐Kehoe (University of Washington)
Año2018
Volumen56
Número12
Páginas1018-1023
Fecha de publicación2018-12-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000991
PMID30234763
OpenAlexW2892401410
IdiomaEN
Citas recibidas2
Referencias citadas12

BACKGROUND: Long-term work disability is known to have an adverse effect on the nation's labor force participation rate. To reduce long-term work disability, the Washington State Department of Labor and Industries established a quality improvement initiative that created 2 pilot Centers of Occupational Health and Education (COHE). OBJECTIVES: To document the level of work disability in a sample of injured workers with musculoskeletal injuries and to examine (8-y) work disability outcomes associated with the COHE health care model. RESEARCH DESIGN: Prospective nonrandomized intervention study with nonequivalent comparison group using difference-in-difference regression models. SUBJECTS: Intervention group represents 18,790 workers with musculoskeletal injuries treated by COHE providers. Comparison group represents 20,992 workers with similar injuries treated within the COHE catchment area by non-COHE providers. MEASURES: Long-term disability outcomes include: (1) on disability 5 years after injury; (2) received a state pension for total permanent disability; (3) received total disability income support through the Social Security Disability Insurance program; or (4) a combined measure including any one of the 3 prior measures. RESULTS: COHE patients had a 30% reduction in the risk of experiencing long-term work disability (odds ratio=0.70, P=0.02). The disability rate (disability days per 1000 persons) over the 8-year follow-up for the intervention and comparison groups, respectively, was 49,476 disability days and 75,832 disability days. CONCLUSIONS: Preventing long-term work disability is possible by reorganizing the delivery of occupational health care to support effective secondary prevention in the first 3 months following injury. Such interventions may have promising beneficial effects on reversing the nation's progressively worsening labor force participation rate

Disability benefits · Disability insurance · Disability pension · Environmental health · Health care · Intervention (counseling) · Logistic regression · Medical model of disability · Occupational safety and health · Odds · Physical therapy · Population · Psychiatry · Quality of life (healthcare) · Social security · Agriculture and Farm Safety · Medicine · Musculoskeletal pain and rehabilitation · Nursing · Occupational Health and Safety Research · Gerontology