{"title":"Patterns of healthcare service utilisation by injured workers following medical certification","authors":"R. Ruseckaite","doi":"10.1017/idm.2014.58","DOIUrl":"https://doi.org/10.1017/idm.2014.58","url":null,"abstract":"Background: Medical certification of injured workers is a routine occurrence in most General Practitioners (GPs) offices. GPs play an important role in return-to-employment after a work-related injury. Objectives: To examine patterns of healthcare service utilisation (HSU) in injured workers by condition and type of medical certificate issued by the GP at the initial consultation. Methods: Zero-inflated negative binomial regression (ZINB) was conducted for major healthcare services accessed by injured workers over the 12-month period post-initial medical examination. Services included GP consultations, pharmacy, physiotherapy, occupational rehabilitation, psychology and others. Logistic regression was conducted for hospital and occupational therapy services. All models were adjusted for the injured worker's gender, age, injury type, certification type, occupation and residential location. Findings: HSU differed according to the type of initial medical certificate and worker condition. Compared to other conditions, for unfit for work (UFW) and alternate duties (ALT) certificates, the average number of physiotherapy services was greater in workers with musculoskeletal disorders (MSD), back pains and strains and fractures. In contrast, for both UFW and ALT certificates, the mean number of psychological services was greater in mental health conditions (MHC). Workers suffering from MHCs were more likely to access pharmacy and psychological services. Workers with ALT certificates were more likely to use GPs, pharmacy and physiotherapy services. They were less likely to access occupational rehabilitation, psychology or other services. Discussion: HSU in the 12 months post-initial medical certification varied substantially according to the worker's medical condition, certificate type, occupation, age, gender and residential location. Conclusion: Understanding these socio-demographic characteristics that influence HSU can facilitate more appropriate resource allocation, strategic thinking on optimal use of particular health services and enable better targeting of particular provider groups for more education on the health benefits of RTW and safe work.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80779801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to select appropriate cases for rehabilitation management - approach of the German Social Accident Insurance","authors":"T. Köhler","doi":"10.1017/idm.2014.43","DOIUrl":"https://doi.org/10.1017/idm.2014.43","url":null,"abstract":"In Germany, people injured in occupational-related accidents are offered comprehensive benefits ranging from medical care to occupational and social reintegration. Statutory accident insurance, funded solely by employers’ contributions, has developed specific structures and practical guidelines for rehabilitation management. This management process involves comprehensive planning, coordination and targeted encouragement and support for those needing rehabilitation. Rehabilitation management must commence promptly, be properly coordinated and achieve long-term effects. The measures deployed aim at restoring health and fitness to work as quickly and comprehensively as possible. In cases involving serious injury, rehabilitation management includes individual counselling and support as a follow-up to the primary medical care and extends beyond medical rehabilitation to include measures that assist occupational and social inclusion. Rehabilitation management demands considerable financial and human resources. To justify this relatively high expenditure, the cases involved need to be identified carefully based on relevant criteria. The accident insurance institutions have investigated how well this works in practice on the basis of their own experience and a wide range of case studies. An extremely important factor is the severity and complexity of the injury. A prognosis of inability to work for more than 112 days determines eligibility as a case needing rehabilitation management because occupational or social integration is at risk. Medical, psychological and social risk factors also need considering, as do the specific occupational requirements. A person's social and professional environment has to be taken into account from the very start. These variables must be examined and analysed as methodically as possible to establish the appropriate course of action.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":"129 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82253576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What lessons can be learned from the perspective of the different actors in DM, especially from companies and social security organisations?","authors":"T. Geisen","doi":"10.1017/idm.2014.17","DOIUrl":"https://doi.org/10.1017/idm.2014.17","url":null,"abstract":"Background: In the context of demographic change and lack of qualified workers the preservation of the internal labour force gains importance for the companies. At the same time private and public income security organisations are increasingly interested in achieving better return to work out-comes in order to reduce their costs. Research shows that a functioning DM leads to more effective return to work in companies. Objectives: The interaction between the welfare state, the companies and private insurers is quite different in each county and highly depending and formed by the established welfare state scheme. In the presentation we will describe the interplay between the different stakeholders in DM for the situation in Switzerland and derive specific challenges and opportunities that arise from this set-ting. Methods: The presentation is based on findings from two studies (2008 and 20013) on disability management in private companies in Switzerland relying on qualitative and quantitative data. The results of these studies will be enriched with first findings from an ongoing international study that compares DM programmes in Switzerland, Australia, Canada and China (2013–2015). Findings: The cooperation between social insurances and the companies could be improved in various ways. Most important is the improvement of informal and institutional communication between the company and the social insurances representatives. But there is also a need to more effective and efficient cooperation in improving rehabilitation processes and the processes of work-place integration. In general the studies show not only that organisational development is needed but also the qualification of DMP’s, as key factors in the processes, need to be improved. Discussion: We will present findings from a study on DM programmes in private companies from 2008, from a study on DM activities in small and medium sized companies 2013 and first results from an on-going international comparative research project mentioned above. What lessons can be learned from the perspective of the different actors in DM, especially from companies and social security organisations? Conclusion: Companies, private insurers and social security organizations will gain new insights into challenges and opportunities of DM. The findings will help to enhance collaboration between these different stakeholders and might provide important insight to improve and enhance existing DM programmes.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84589205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Realising the health benefits of safe work - a continuing professional education for primary care practitioners","authors":"Kevin Sleigh","doi":"10.1017/IDM.2014.34","DOIUrl":"https://doi.org/10.1017/IDM.2014.34","url":null,"abstract":"Background: General Practitioners complete around 91% of compensable certificates, and play a significant role in promoting the awareness of the health benefits of work. The Australasian Consensus Statement on the Health Benefits of Work developed by the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) has been endorsed by 100 organisations including the Royal Australian College of General Practitioners (RACGP). The Victorian WorkCover Authority and TAC has undertaken a program of work focussing on the delivery of a general practice education and awareness raising program. Objectives: The objectives of the program were to; engage Medicare Locals to undertake a general practice education and awareness raising program, develop training materials for Medicare Local staff to undertake practice liaison visits, recruit and train General Practice peer educators to deliver in-practice education and develop and deliver content for continuing professional development events in selected Medicare Locals. Methods: A suite of educational resources were developed and tailored to suit delivery in a General Practice setting. The Medicare Locals were targeted if they had high certification rates, the educational events were delivered in-practice settings and Principal findings The practice target was reached in all Medicare Locals, a total of 457 general practices across the five Medicare Locals were visited. The program was successful in raising awareness of the health benefits of work amongst GPs and practice staff. Discussion: The education has given general practitioners the impetus to talk to patients early about the health benefits of work and has the potential for GPs to be more confident in their clinical management of compensable patients. Conclusion: That the educational program continue with the Victorian WorkCover Authority and TAC working with key peak bodies and medical colleges to ensure education about the Health Benefits of Safe Work become a mandatory component of all GP postgraduate training.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81402652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Taking a practical look at the Americans with Disabilities Act (ADA) in the United States","authors":"Carrie Bibens","doi":"10.1017/IDM.2014.48","DOIUrl":"https://doi.org/10.1017/IDM.2014.48","url":null,"abstract":"This presentation will provide a practical look at the Americans with Disabilities Act (ADA) in the United States. This disability non-discrimination act has undergone recent amendments changing the landscape for employers and changing their responsibilities to stay compliant. We will review how the changes in the ADA differ today for employers in the United States and we will also provide a comparison with other discriminatory acts in the world. The changes to be discussed include issues of “qualification” and “reasonableness” of accommodation and what these changes mean to real employer examples. The example will demonstrate one disability insurance carrier's approach to addressing this change by providing in support of their policyholders’ responsibilities to stay compliant.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":"1068 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77274893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Developing the Social Security Organisation (SOCSO) of Malaysia's RTW case management system","authors":"E. Cheong","doi":"10.1017/IDM.2014.45","DOIUrl":"https://doi.org/10.1017/IDM.2014.45","url":null,"abstract":"The Social Security Organisation (SOCSO) of Malaysia introduced the Return to Work (RTW) Program in 2007 which is a comprehensive multidisciplinary biopsychosocial rehabilitation program for its Insured Persons who are experiencing disability due to accidents in the workplace or those claiming for invalidity. This rehabilitation program is unique as it involves the concept of “disability management” in which each Insured Person who is referred to the program, is assigned to a Disability Case Manager who is actively involved throughout the return to work process. Up to date (December 2013), 11,090 workers were motivated to participate in the SOCSO RTW Programme, and this requires many work processes, countless paper-work and massive physical files and document management. Due to this massive information flow, the demand for a more efficient information system is needed. From the beginning, the whole idea was to create an accessible, quick and user-friendly application. The application is now used by the SOCSO RTW Department in managing their information. This application was built on an open source platform which can be access through the internet. It is also a “learning application” where it uses its historical data to assist the case managers to generate standard rehabilitation plans and forecast possible return to work outcomes. The beauty of such application is that it is easily replicated, configurable (email notifications, reminders, etc) to meet the needs of the case managers in various jurisdiction. The scope of the application can also be easily defined to meet the size of an enterprise using the application. With better management of information, this application has contributed in reducing processing time, repetitive paperwork, minimal storage areas and almost real-time flow of information in the SOCSO's RTW Case Management system. Apart from that, the application now stores a wealth of information such as rehabilitation strategies for various disability or illnesses or demographic backgrounds.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82080944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Australia's National Injury Insurance Scheme - design, challenges and opportunities","authors":"A. Fronsko","doi":"10.1017/idm.2014.36","DOIUrl":"https://doi.org/10.1017/idm.2014.36","url":null,"abstract":"This presentation will focus on history and economic theory perspectives, using benchmark comparisons across Australian jurisdictions and leveraging materials in the public domain. The aim is to assist practitioners refine and manage their NIIS schemes for long term viability and customer/participant outcomes. The presentation will look at the Genesis of National Injury Insurance Schemes in Australia – a brief history of thinking that has shaped NIIS design, scheme Design model and rationale for a NIIS including Rationale for separating the NIIS and NDIS, What the “I” in NDIS really means, the Benchmark comparison of NDIS versus NIIS design feature and the staged approach to migrate to universal accident compensation. Moving on to exploring. NIIS Implementation Update - Motor Accident Compensation including a benchmark comparison - design models in 5 Australian CTP Jurisdiction. And finally a look at Insurance Claims Management vs Disability Management before speaking about the Next steps for NIIS and integration or possible alignment opportunities with the NDIS.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":"2015 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86921112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Motivational Interactions: a client-centred engagement strategy in Australian accident compensation schemes","authors":"A. Papagiannis","doi":"10.1017/idm.2014.67","DOIUrl":"https://doi.org/10.1017/idm.2014.67","url":null,"abstract":"Motivational interactions is based on the foundations of “Motivational interviewing” and the “Transtheoretical Model of Behaviour Change”, Which is widely recognised as an important engagement strategy for people working in a case management capacity- working with a range of injured client/worker needs pertaining to resistance, ambivalence to change, motivation, development and return to work. The quality of the working relationship between the worker and client is said to be a significant predictor of outcomes for a client. Evidence has indicated that a collaborative positive client centred engagement that is responsive to the change process of individuals is a reliable indicator of outcomes in a range of mental health, psychosocial and physical injury issues e.g. stress, depression, anxiety, physical injury, disability, with positive relationships being correlated with better Return to work/Life outcomes.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87304543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Challenges to disability management from an expanding fly-in fly-out workforce","authors":"H. Biggs","doi":"10.1017/IDM.2014.49","DOIUrl":"https://doi.org/10.1017/IDM.2014.49","url":null,"abstract":"Australia's mineral, resource and infrastructure sectors continues to expand as operations in rural and remote locations increasingly rely on fly-in, fly-out or drive-in, drive-out workforces in order to become economically competitive. The issues associated with employing these workforces are becoming more apparent and include a range of physical, mental, psychosocial, safety, and community challenges. Research evaluating the impacts of fly-in, fly-out operations in Australia has been limited, and in February 2013 the Australian House of Representatives Standing Committee on Regional Australia made 21 recommendations aimed at improving these operations. To date, none of the recommendations have been implemented. The Construction and Mining sectors, in which most FIFO workers are employed, represent 12% of the total Australian workforce. Recent evidence from Safe Work Australia (2013) notes that serious injuries incident rates in both these sectors are well above the national injury rate. In addition the median payment and compensation cost for serious injury in these sectors are considerably higher than the Australian average due to higher employees salary, severity of incidents, lengths of absence from work, and medical expenses. These at risk remote site FIFO employees are further challenged post injury by lack of access to well-regarded disability management processes that have traditionally closely involved the workplace in the rehabilitation process. This paper examines the disparate challenges faced by both employers and employees in workplace wellbeing in remote sites, and raises questions as to how best disability management professionals can design, implement, and evaluate effective rehabilitation processes for injured FIFO workers who are a fast growing segment of the workforce but who work in conditions hitherto atypical of mainstream industry.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87200710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Navigating work disability paradigms and reform in Canada","authors":"E. Tompa","doi":"10.1017/idm.2014.13","DOIUrl":"https://doi.org/10.1017/idm.2014.13","url":null,"abstract":"Objective: We investigate labour-market earnings of workers’ compensation claimants from three distinctly different workers’ compensation insurance support programs for claimants with permanent impairments. These three programs, which existed in Ontario, Canada in different periods over the last 25 years, are the Permanent Disability (PD) program, the Future Economic Loss (FEL) program, and the Loss of Earnings (LOE) program. The nature of benefit determination and the return to work supports provided by three programs are very different. The focus of the study is on evidence of programmatic impact on labour-market earnings recovery trajectories over nine years post injury. Methods: The study included claimants sampled from each of the three programs who sustained a permanent impairment from a work injury. Claimants were identified in a Revenue Canada tax file database known as the Longitudinal Administrative Databank (LAD), which is a longitudinal 20% simple random sample of all Canadian tax filers. Each claimant was matched with similar uninjured controls that were also in the LAD, based on sex, age, labour-market earnings amounts and trajectories in the four years prior to injury, and a propensity score. Statistical modeling analysis was undertaken to compare the labour-market earnings trajectories of claimants relative to their matched controls using data on earnings over the nine years post injury. Analyses focused on sub-strata defined by program, sex, age, permanent impairment level, and pre-injury earnings. A key issue of interest was to determine which program of supports resulted in the best labour-market earnings recovery. Results: Five distinct earnings recovery trajectories were identified. Claimants in various demographic and pre-injury earnings sub-strata from the LOE program cohort had a statistically significant lower probability of the lowest earnings recovery trajectory, and higher probability of the second highest trajectory compared to the PD cohort. Results for the LOE program were similar to the FEL program. Conclusions: Injured workers from the LOE program appear to fare better than claimants from the PD program and similarly to those from the FEL program in terms of labour-market earnings recovery over the nine years post injury. Across all programs, older claimants fare more poorly, and women fare worse than men in terms of labour-market earnings recovery.","PeriodicalId":53532,"journal":{"name":"International Journal of Disability Management","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86107252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}