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

A Prospective Cohort Study

Abstract

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.