Investing in occupational health "best practices" improves outcomes for injured workers, study finds

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A new study of occupational health care in Washington state shows that improving medical care for injured workers can dramatically reduce lost work time.

The study is published in the December 2011 issue of the American Public Health Association journal, Medical Care. Dr. Gary Franklin, medical director for the Department of Labor & Industries (L&I), was one of the researchers involved in the study; Dr Thomas Wickizer, Ohio State University, College of Public Health, was the lead investigator.

“Work-related disability is a major public health problem that’s largely overlooked in the U.S.,” Dr. Franklin said. “This study shows that using occupational health best practices when treating injured workers can have an important effect on their recovery.”

A few years ago, L&I first teamed up with physicians in Washington and throughout the country, health care researchers at the University of Washington, as well as business and labor leaders to find ways of helping workers in the first 12 weeks after a work-related injury.

The result of that work was the creation of L&I’s Centers of Occupational Health and Education (COHE). COHEs are community-based organizations that work with medical providers to encourage the best ways to treat injured workers.

These “best practices” focus on the safe, healthy return of injured workers to full function and full employment. Examples of best practices include promptly filing the workers’ compensation claim, phoning the employer to talk about the worker’s ability to return to work or a light-duty job, and regularly assessing a worker’s ability to do work activities.

L&I gives COHE health care providers financial incentives and organizational support to get injured workers back to work sooner. A key component of the COHEs is using health services coordinators, who report to the health care delivery team and assist with community-wide integration of care.

The overall effort at improved integration of care through the use of best practices and appropriate incentives is an early model of what has been envisioned in the accountable-care organization concept under U.S. health care reform.

For the study, seven researchers from L&I, the College of Public Health at Ohio State University, and the University of Washington’s Department of Environmental and Occupational Health Sciences analyzed 105,607 workers’ compensation claims filed from July 2001 through June 2007, both COHE and non-COHE claims.

The study found that injured workers treated by health-care providers operating under COHE best practices had 19.7 percent fewer disability days than other injured workers receiving treatment, and a reduction in total disability and medical costs of $510 per claim.

Workers suffering from back strain had a reduction in disability days of 29.5 percent.

“We’re especially encouraged that the outcomes for workers with low-back strain were significantly better,” said Dr. Franklin. “Lower-back strain is a costly and common disabling condition in workers’ compensation.”

Currently, four COHE sites serve 2,000 providers and hundreds of employers, treating about one-third of injured workers in Washington. The findings of the study led to new legislation earlier this year that will expand access to COHEs to all injured workers in the state by 2015.

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For media information: Elaine Fischer, L&I, 360-902-5413.

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