Impact of a New Program of Care for Work-Related Mild Traumatic Brain Injury on Recovery and Return to Work.

Abstract

Background: The Workplace Safety and Insurance Board (WSIB) in Ontario, Canada, launched a new community-based mild traumatic brain injury (mTBI) program of care (POC) in November 2020. The new program included graded exercise therapy and vestibular rehabilitation (where required). The objective of this study was to assess the impact of the new mTBI POC on recovery and return to work among patients who suffered a work-related mTBI.

Methods: We identified WSIB claims that accessed the previous and new mTBI POC over a 4-year timeframe (October 1, 2017, to September 30, 2019, and July 1, 2021, to June 30, 2023). A quasi-experimental pre-post study, propensity score matching design with a difference-in-difference modelling component was applied to approximate estimation of causal effects on loss of earnings (LOE) benefit duration at 3-, 6-, and 12-months and HC costs for patients treated in the previous and new programs.

Results: Over the 4-year timeframe, 5625 patients accessed the previous and new mTBI POC. The new program achieved improved 3-, 6-, and 12-month disability durations (incremental percentage difference of -11.7%, -9.3%, and -9.0%, respectively), and shorter durations of disability, reflected by decreased LOE benefit costs (incremental percentage difference of -32.6%) and decreased HC costs (incremental percentage difference of -5.6%). The overall combined savings in LOE and HC costs was 21%.

Conclusions: This analysis indicates that the implementation of this new evidence based mTBI POC resulted in improved outcomes (decreased disability duration and lower health care utilization) on a per patient basis for people with work-related mTBI.