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Health Care Provider Communication and the Duration of Time Loss Among Injured Workers

A Prospective Cohort Study

Lane, Tyler J. DPhil*; Lilley, Rebbecca PhD; Black, Oliver PhD*,‡; Sim, Malcolm R. PhD*; Smith, Peter M. PhD*,§,∥

doi: 10.1097/MLR.0000000000001160
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Background: In addition to providing injured workers with biomedical treatment, health care providers (HCPs) can promote return to work (RTW) through various communications.

Objectives: To test the effect of several types of HCP communications on time loss following injury.

Research Design: The authors analyzed survey and administrative claims data from a total of 730 injured workers in Victoria, Australia. Survey responses were collected around 5 months postinjury and provided data on HCP communication and confounders. Administrative claim records provided data on compensated time loss postsurvey. The authors conducted multivariate zero-inflated Poisson regressions to determine both the odds of having future time loss and its duration.

Measures: Types of HCP communications included providing an estimated RTW date, discussing types of activities the injured worker could do or ways to prevent a recurrence, and contacting other RTW stakeholders. Each was measured in isolation as well as modified by a low-stress experience with the HCP. Time loss was the count of cumulative compensated work absence in weeks, accrued postsurvey.

Results: RTW dates reduced the odds of future time loss [odds ratio, 0.26; 95% confidence interval (CI), 0.09–0.82] regardless of the stressfulness of the experience. Communications that predicted shorter durations of time loss only did so with low-stress experiences: RTW date [incidence rate ratio (IRR), 0.56; 95% CI, 0.50–0.63], stakeholder contact (IRR, 0.78; 95% CI, 0.70–0.87), and prevention discussions (IRR, 0.87; 95% CI, 0.78–0.98).

Conclusions: HCPs may reduce time loss through several types of communication, particularly when stress is minimized. RTW dates had the largest and most robust effect.

*Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia

Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

Faculty of Business and Law, Deakin University, Geelong, Vic., Australia

§Institute for Work & Health

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

Supported by Australian Research Council via a Linkage Grant (LP130100091).

The authors declare no conflict of interest.

Reprints: Tyler J. Lane, DPhil, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Vic 3141, Australia. E-mail: tyler.lane@monash.edu.

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