Evaluating Effectiveness of Telerehabilitation Services Among Injured Workers Treated in a Canadian Workers' Compensation System: A Population-Based Study.

IF 2.1 3区医学 Q1 REHABILITATION

Journal of Occupational Rehabilitation Pub Date : 2024-12-01 Epub Date: 2024-01-24 DOI:10.1007/s10926-023-10165-9

Katelyn Brehon, Gagan Nagra, Maxi Miciak, Riikka Niemeläinen, Douglas P Gross

{"title":"Evaluating Effectiveness of Telerehabilitation Services Among Injured Workers Treated in a Canadian Workers' Compensation System: A Population-Based Study.","authors":"Katelyn Brehon, Gagan Nagra, Maxi Miciak, Riikka Niemeläinen, Douglas P Gross","doi":"10.1007/s10926-023-10165-9","DOIUrl":null,"url":null,"abstract":"Purpose: To evaluate the effectiveness of telerehabilitation for promoting return-to-work (RTW) among injured workers.Methods: We conducted a pragmatic, quasi-experimental study comparing telerehabilitation, in-person, or hybrid services. Descriptive statistics analyzed demographics, occupational factors, and patient-reported outcome measures (PROMs). Kruskal-Wallis tests investigated differences between mode of delivery and changes in PROM scores. Logistic and Cox-proportional hazard regression examined associations between mode of delivery and RTW status or days receiving wage replacement benefits in the first-year post-discharge, respectively, while controlling for potential confounders.Results: A slightly higher percentage of the 3,708 worker sample were male (52.8%). Mean (standard deviation (SD)) age across all delivery formats was 45.5 (12.5) years. Edmonton zone had the highest amount of telerehabilitation delivery (53.5%). The majority of workers had their program delivered in a hybrid format (54.1%) and returned to work (74.4%) at discharge. All PROMs showed improvement although differences across delivery formats were not clinically meaningful. Delivery via telerehabilitation had significantly lower odds of RTW at discharge (Odds Ratio: 0.82, 95% Confidence Interval: 0.70-0.97) and a significantly lower risk of experiencing suspension of wage replacement benefits in the first year following discharge (Hazard Ratio: 0.92, 95% Confidence Interval: 0.84-0.99). Associations were no longer significant when confounders were controlled for.Conclusion: RTW outcomes were not statistically different across delivery formats, suggesting that telerehabilitation is a novel strategy that may improve equitable access and earlier engagement in occupational rehabilitation. Factors such as gender and geographic location should be considered when deciding on service delivery format.","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":"793-802"},"PeriodicalIF":2.1000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Occupational Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10926-023-10165-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/24 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To evaluate the effectiveness of telerehabilitation for promoting return-to-work (RTW) among injured workers.

Methods: We conducted a pragmatic, quasi-experimental study comparing telerehabilitation, in-person, or hybrid services. Descriptive statistics analyzed demographics, occupational factors, and patient-reported outcome measures (PROMs). Kruskal-Wallis tests investigated differences between mode of delivery and changes in PROM scores. Logistic and Cox-proportional hazard regression examined associations between mode of delivery and RTW status or days receiving wage replacement benefits in the first-year post-discharge, respectively, while controlling for potential confounders.

Results: A slightly higher percentage of the 3,708 worker sample were male (52.8%). Mean (standard deviation (SD)) age across all delivery formats was 45.5 (12.5) years. Edmonton zone had the highest amount of telerehabilitation delivery (53.5%). The majority of workers had their program delivered in a hybrid format (54.1%) and returned to work (74.4%) at discharge. All PROMs showed improvement although differences across delivery formats were not clinically meaningful. Delivery via telerehabilitation had significantly lower odds of RTW at discharge (Odds Ratio: 0.82, 95% Confidence Interval: 0.70-0.97) and a significantly lower risk of experiencing suspension of wage replacement benefits in the first year following discharge (Hazard Ratio: 0.92, 95% Confidence Interval: 0.84-0.99). Associations were no longer significant when confounders were controlled for.

Conclusion: RTW outcomes were not statistically different across delivery formats, suggesting that telerehabilitation is a novel strategy that may improve equitable access and earlier engagement in occupational rehabilitation. Factors such as gender and geographic location should be considered when deciding on service delivery format.

查看原文本刊更多论文

评估加拿大工伤赔偿体系中受伤工人接受远程康复服务的效果：基于人口的研究。

目的：评估远程康复在促进受伤工人重返工作岗位（RTW）方面的有效性：我们进行了一项务实的准实验研究，比较了远程康复、面对面服务或混合服务。描述性统计分析了人口统计学、职业因素和患者报告结果指标（PROMs）。Kruskal-Wallis 检验调查了提供方式与 PROM 评分变化之间的差异。在控制潜在混杂因素的情况下，逻辑回归和 Cox 比例危险回归分别检验了分娩方式与出院后第一年的 RTW 状态或领取工资替代津贴天数之间的关系：在 3 708 名工人样本中，男性比例略高（52.8%）。所有服务形式的平均年龄（标准差）为 45.5 (12.5)岁。埃德蒙顿区的远程康复服务数量最多（53.5%）。大多数患者的康复项目是以混合形式提供的（54.1%），出院时重返工作岗位的比例为 74.4%。所有的 PROMs 都有改善，尽管不同实施形式之间的差异没有临床意义。通过远程康复提供服务的患者出院时重返工作岗位的几率明显较低（风险比：0.82，95% 置信区间：0.70-0.97），出院后第一年被暂停工资替代福利的风险也明显较低（风险比：0.92，95% 置信区间：0.84-0.99）。在对混杂因素进行控制后，相关性不再显著：不同服务形式的复工结果在统计学上并无差异，这表明远程康复是一种新颖的策略，可以改善公平获取和更早参与职业康复的情况。在决定服务形式时，应考虑性别和地理位置等因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Occupational Rehabilitation Multiple-

CiteScore

5.80

自引率

12.10%

发文量

期刊介绍： The Journal of Occupational Rehabilitation is an international forum for the publication of peer-reviewed original papers on the rehabilitation, reintegration, and prevention of disability in workers. The journal offers investigations involving original data collection and research synthesis (i.e., scoping reviews, systematic reviews, and meta-analyses). Papers derive from a broad array of fields including rehabilitation medicine, physical and occupational therapy, health psychology and psychiatry, orthopedics, oncology, occupational and insurance medicine, neurology, social work, ergonomics, biomedical engineering, health economics, rehabilitation engineering, business administration and management, and law. A single interdisciplinary source for information on work disability rehabilitation, the Journal of Occupational Rehabilitation helps to advance the scientific understanding, management, and prevention of work disability.