Which Characteristics are Associated with the Timing of the First Healthcare Consultation, and Does the Time to Care Influence the Duration of Compensation for Occupational Back Pain?

Purpose To identify the characteristics associated with the timing of the first healthcare consultation and to measure the impact of that timing on the duration of the first episode of compensation for occupational back pain following the injury. Methods We analyzed data from a cohort of workers wit...

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Bibliographic Details
Published in:	Journal of occupational rehabilitation 2017-09, Vol.27 (3), p.359-368
Main Authors:	Blanchette, Marc-André, Rivard, Michèle, Dionne, Clermont E., Steenstra, Ivan, Hogg-Johnson, Sheilah
Format:	Article
Language:	eng
Subjects:	Age Factors Back injuries Back pain Backache Clinical Psychology Compensation Consultation Consulting Data processing Disability Evaluation Employers Environmental Health Female Health care Health care industry Health Psychology Humans Injury analysis Injury Severity Score Kaplan-Meier Estimate Low Back Pain - therapy Male Males Medicine Medicine & Public Health Occupational Injuries - therapy Occupational Medicine/Industrial Medicine Occupational safety Ontario Orthopedics Pain Personal injuries Profits Proportional Hazards Models Rehabilitation Retrospective Studies Return to work programs Sex Factors Time measurement Time-to-Treatment Workers' Compensation - statistics & numerical data
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Summary:	Purpose To identify the characteristics associated with the timing of the first healthcare consultation and to measure the impact of that timing on the duration of the first episode of compensation for occupational back pain following the injury. Methods We analyzed data from a cohort of workers with compensated back pain in 2005 in Ontario obtained from the Workplace Safety and Insurance Board. Cox multivariable survival models were performed to identify factors associated with the time to care and to measure its association with the length of the first episode of 100 % compensation. Results Among the 5520 claims analyzed, 93.7 % of workers accessed care within the first week (average = 2.1 days; median = 1 day). Time to care was shorter for males, for workers who had received previous compensation and for those with access to an early return to work program. Age, number of employees in the company and personal earnings were positively associated with the time to care. More severe nature of injury, employers doubt about the work-relatedness of the injury and consulting a physiotherapist as the first healthcare provider were also associated with longer time to care. Considering potential confounders, longer time to care was significantly associated with a delay in the end of the first episode of compensation (hazard ratio = 0.98; P
ISSN:	1053-0487 1573-3688