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What to Make of Injured Workers Who Don't Get Better

Posted on: 03/15/2004
Many adults have a work-related injury. Most return to work quickly. What happens to the workers who don't get better and end up with a long-term (chronic) musculoskeletal problem? How are they different from the workers who go back to work with little lost time?

That's the subject of this study from the Productive Rehabilitation Institute of Dallas for Ergonomics (PRIDE). A large number of patients (over 1,000) were put into two groups: those who finished rehab without further health care visits, and those who didn't. The second group visited at least one new health care provider after rehab was over.

The results of this study are important because chronic cases of disability account for a large amount of the money spent on health care for musculoskeletal problems. Some patients see many doctors for the same problem. Studies show there are many reasons why patients go "doctor shopping." All of them lead to one thing: increased health-care costs.

The authors found that 90 percent of the group who didn't visit a new health care provider (group zero) returned to work. They were still working a year later. On the other hand, 78 percent of the group who did seek more health care (group one) went back to work. Only 68 percent were still at work a year later.

Group zero settled all legal and financial issues linked to the injury. Only 77 percent of group one was able to do the same. The researchers noticed lower socioeconomic groups tend to use the health care system more. Group one had a much higher number of patients who had another operation at the site of injury. Overall, 25 percent of the patients in group one lost the most work, used the health care system the most, and had more legal problems than group zero.

The authors say these findings will help us understand workers' compensation costs. Patients who stop working also look for other sources of money, such as continued workers' compensation, Social Security disability, and welfare. The patients may use the ongoing health care visits as a way to prove they are disabled. In this way they try to qualify for more benefits.

The authors also say there is a need for more research. If we can tell who will develop chronic problems, it may be possible to prevent them early on. Finding risk factors for treatment failure can help doctors screen patients ahead of time and prevent disability.

References:
Timothy J. Proctor, PhD, et al. Unremitting Health-Care-Utilization Outcomes of Tertiary Rehabilitation of Patients with Chronic Musculoskeletal Disorders. In The Journal of Bone and Joint Surgery. January 2004. Vol. 86-A. No. 1. Pp. 62-69.

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