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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



Details

  • Personal Author:
  • Description:
    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. [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • ISSN:
    0025-7079
  • Document Type:
    Text
  • Funding:
    Grant
  • Genre:
    Journal Article
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Volume:
    56
  • Issue:
    12
  • NIOSHTIC Number:
    nn:20055212
  • Citation:
    Med Care 2018 Dec; 56(12):1018-1023
  • Contact Point Address:
    Thomas M. Wickizer, PhD, College of Public Health, 202 Cunz Hall, The Ohio State University, 1843 Neil Avenue, Columbus, OH 43210
  • Email:
    wickizer.5@osu.edu
  • Federal Fiscal Year:
    2019
  • Performing Organization:
    University of Washington
  • Peer Reviewed:
    True
  • Start Date:
    20050701
  • Source Full Name:
    Medical Care
  • End Date:
    20250630
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:0458e990adfc89c58f8b51151a637b030f64889625c73634bb3f86c677b335db58222724e0fc61b495cb0e22f329b2b2b94cf80ab0d6d89ceb60fe51629f036b
  • Download URL:
  • File Type:
    Filetype[PDF - 120.39 KB ]
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