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Scollay CE, Berecki-Gisolf J, Grant GM. Trends in lawyer use in road traffic injury compensation claims. PLoS One 2020; 15:e0231025. [PMID: 32251480 PMCID: PMC7135282 DOI: 10.1371/journal.pone.0231025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/15/2020] [Indexed: 11/25/2022] Open
Abstract
Injury compensation claimants use legal services to help them navigate compensation schemes, including accessing benefits and resolving disputes. Little is known, however, about the extent of lawyer use by compensation claimants, including changes over time. This paper presents findings from one of the largest empirical investigations of lawyer use in an injury compensation setting to date. Using evidence from more than 275,000 claims in the road traffic injury scheme in the state of Victoria, Australia, this study examines the prevalence of, and changes in, lawyer use between 2000 and 2015. The analysis identifies a significant increase in the use of lawyers in the scheme, and explores possible explanations. This study provides critical insights into lawyer use in compensation settings: the steep increase in lawyer involvement has both access to justice and financial implications for compensation schemes, given the associations between lawyer use, claimant outcomes, and long-term scheme viability.
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Affiliation(s)
- Clare E. Scollay
- Faculty of Law, Monash University, Melbourne, Victoria, Australia
| | - Janneke Berecki-Gisolf
- Monash University Accident Research Centre, Monash University, Melbourne, Victoria, Australia
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Impact of Collaborative Care on Absenteeism for Depressed Employees Seen in Primary Care Practices: A Retrospective Cohort Study. J Occup Environ Med 2019; 60:83-89. [PMID: 28961593 DOI: 10.1097/jom.0000000000001173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The impact of "real world" collaborative care on depression and absenteeism for depressed employees seen in primary care practices using objective employer absence data. METHODS A retrospective cohort study comparing depressed employees seen in primary care practices who enrolled for a "real world" collaborative care program to practice as usual (PAU) on objective absence days and depression response and remission at 6, and 12-month time periods. RESULTS Absence days were more in the collaborative care group compared with the PAU group at 3 and 6 months but at 12 months the difference was no longer statistically significant. Collaborative care led to better response and remission depression scores compared with PAU at 12 months. CONCLUSIONS Collaborative care led to faster improvement in depression symptoms but did not translate to less time away from work.
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Hudon A, Lippel K, MacEachen E. Mapping first-line health care providers' roles, practices, and impacts on care for workers with compensable musculoskeletal disorders in four jurisdictions: A critical interpretive synthesis. Am J Ind Med 2019; 62:545-558. [PMID: 31074020 DOI: 10.1002/ajim.22972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND First-line health care providers are the primary access point for workers' benefits. However, little is known about their impact on quality of care and return-to-work. Our objective was to critically compare literature on the practices of first-line providers for workers with musculoskeletal injuries in Ontario and Quebec (Canada), Washington State (United States), and Victoria (Australia). METHODS A critical interpretive synthesis of peer-reviewed scientific literature was conducted. The search across six databases yielded 59 relevant publications that were critically appraised. RESULTS Three themes emerged: 1) how policies about first-line health care providers' modulate worker access to care, 2) how these providers' roles, practices, and training shape disability management, and 3) how the quality of care and disability outcomes are evaluated. CONCLUSIONS First-line health care providers have a critical influence on workers' trajectories of care. A focus on their role while taking the complexity of the context into account will help orient future policy changes.
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Affiliation(s)
- Anne Hudon
- Faculty of Applied Health SciencesSchool of Public Health and Health Systems, University of WaterlooOntario Canada
- Faculty of LawCivil Law Section, University of OttawaOntario Canada
| | - Katherine Lippel
- Faculty of LawCivil Law Section, University of OttawaOntario Canada
| | - Ellen MacEachen
- Faculty of Applied Health SciencesSchool of Public Health and Health Systems, University of WaterlooOntario Canada
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Donovan M, Khan A, Johnston V. The Effect of a Workplace-Based Early Intervention Program on Work-Related Musculoskeletal Compensation Outcomes at a Poultry Meat Processing Plant. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:24-34. [PMID: 26880190 DOI: 10.1007/s10926-016-9628-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Introduction The aim of this study is to determine whether a workplace-based early intervention injury prevention program reduces work-related musculoskeletal compensation outcomes in poultry meat processing workers. Methods A poultry meatworks in Queensland, Australia implemented an onsite early intervention which included immediate reporting and triage, reassurance, multidisciplinary participatory consultation, workplace modifica tion and onsite physiotherapy. Secondary pre-post analyses of the meatworks' compensation data over 4 years were performed, with the intervention commencing 2 years into the study period. Outcome measures included rate of claims, costs per claim and work days absent at an individual claim level. Where possible, similar analyses were performed on data for Queensland's poultry meat processing industry (excluding the meatworks used in this study). Results At the intervention meatworks, in the post intervention period an 18 % reduction in claims per 1 million working hours (p = 0.017) was observed. Generalized linear modelling revealed a significant reduction in average costs per claim of $831 (OR 0.74; 95 % CI 0.59-0.93; p = 0.009). Median days absent was reduced by 37 % (p = 0.024). For the poultry meat processing industry over the same period, generalized linear modelling revealed no significant change in average costs per claim (OR 1.02; 95 % CI 0.76-1.36; p = 0.91). Median days absent was unchanged (p = 0.93). Conclusion The introduction of an onsite, workplace-based early intervention injury prevention program demonstrated positive effects on compensation outcomes for work-related musculoskeletal disorders in poultry meat processing workers. Prospective studies are needed to confirm the findings of the present study.
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Affiliation(s)
- Michael Donovan
- Division of Physiotherapy, The University of Queensland, Brisbane, QLD, 4072, Australia.
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Venerina Johnston
- Division of Physiotherapy, The University of Queensland, Brisbane, QLD, 4072, Australia
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Prang KH, Hassani-Mahmooei B, Collie A. Compensation Research Database: population-based injury data for surveillance, linkage and mining. BMC Res Notes 2016; 9:456. [PMID: 27716308 PMCID: PMC5045595 DOI: 10.1186/s13104-016-2255-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 09/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Compensation health research aims to study the influence of compensation systems, processes and practices on health and health-related outcomes. In many jurisdictions, injury compensation authorities collect substantial volumes of case and service level data for the purpose of administering the compensation system. An important secondary use of such data is research and analysis to explore interactions between individuals and organisations in compensation systems, and between compensation and other systems including healthcare and legal systems, in order to understand the role of compensation processes in injury recovery. RESULTS The Compensation Research Database (CRD) established at the Institute for Safety Compensation and Recovery Research at Monash University, holds over 20 years of population-based data for transport and workplace injury in the state of Victoria, Australia. The CRD is unique in that it is held independently, at arm's length from the compensation authorities that collect the data, and its primary purpose is to support research and analyses to develop new insights into system and individual level outcomes. This paper describes the core elements of the database including the design, process and type of information collected. We review some of the research findings that have been published using the CRD, and describe the ongoing program of research utilising the database. CONCLUSIONS The CRD is a unique administrative database that supports research into compensation health, with the objective of improving understanding of the interaction between injury compensation systems and injury recovery. The availability of the CRD for independent research is leading to substantial advancements in the compensation health research field and in related areas.
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Affiliation(s)
- Khic-Houy Prang
- Institute for Safety, Compensation and Recovery Research, Monash University, Level 18, 222 Exhibition Street, Melbourne, VIC, 3000, Australia. .,Monash University Accident Research Centre, Monash University, Clayton, VIC, 3800, Australia.
| | - Behrooz Hassani-Mahmooei
- Institute for Safety, Compensation and Recovery Research, Monash University, Level 18, 222 Exhibition Street, Melbourne, VIC, 3000, Australia
| | - Alex Collie
- Institute for Safety, Compensation and Recovery Research, Monash University, Level 18, 222 Exhibition Street, Melbourne, VIC, 3000, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia
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Ruseckaite R, Collie A, Prang KH, Brijnath B, Kosny A, Mazza D. Does medical certification of workers with injuries influence patterns of health service use? Work 2016; 54:669-78. [PMID: 27286076 DOI: 10.3233/wor-162312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Among workers with injuries who seek compensation, a general practitioner (GP) usually plays an important role in a person's return to work (RTW) by advising if the worker is unfit for work (UFW), is able to work on alternate (ALT) duties or is fit for work and also providing referrals to other health service providers. OBJECTIVE To examine patterns of health service utilization (HSU) in workers with injuries by condition and type of certificate issued by GP. METHODS Zero-inflated negative binomial and logistic regressions were conducted for major healthcare services accessed over the 12-month period post-initial medical examination. Services included GP consultations, pharmacy, physiotherapy, occupational rehabilitation and psychology. RESULTS The average number of physiotherapy services was greater in workers with musculoskeletal disorders, back pain and fractures. In contrast, the median number of psychological services was greater in mental health conditions (MHC). Workers with ALT certificates were more likely to use GPs, pharmacy and physiotherapy services. CONCLUSION HSU in the 12 months post-initial medical certification varied substantially according to the worker's condition, certificate type, age, gender and residential location. Understanding these factors can facilitate more appropriate resource allocation; strategic thinking on optimal use of particular health services and enables better targeting of particular provider groups for more education on the health benefits of RTW.
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Affiliation(s)
- Rasa Ruseckaite
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, The Alfred Hospital, Melbourne, VIC, Australia
| | - Alex Collie
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - Khic-Houy Prang
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.,Monash Injury Outcomes Unit, Monash Injury Research Institute, Monash University, Clayton, VIC, Australia
| | - Bianca Brijnath
- Department of General Practice, School of Primary Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, VIC, Australia.,Faculty of Health Sciences, School of Occupational Therapy and Social Fork, Curtin University, Bentley, WA, Australia
| | - Agnieszka Kosny
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, The Alfred Hospital, Melbourne, VIC, Australia.,Institute for Work and Health, Toronto, ON, Canada
| | - Danielle Mazza
- Department of General Practice, School of Primary Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, VIC, Australia
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Wynne-Jones G, Dunn KM. Has there been a change in the rates of UK sickness certification for back pain over time? An examination of historical data from 2000 to 2010. BMJ Open 2016; 6:e009634. [PMID: 27113234 PMCID: PMC4853988 DOI: 10.1136/bmjopen-2015-009634] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This paper aims to investigate historical patterns of sickness certification for back pain from 2000 to 2010. DESIGN Electronic medical records from 14 practices that are part of the National Institute for Health Research (NIHR) Clinical Research Network: West Midlands were reviewed. All records for back pain consultations from 2000 to 2010 were downloaded and matched, by date, to corresponding sickness certification records. SETTING Primary Care. RESULTS A total of 93,896 back pain consultations were recorded over the 11-year period, resulting in 30,913 sickness certificates. There was a statistically significant decrease in the rate of certification over the period, falling from 376.8 (95% CI 362.1 to 392) per 1000 back pain consultations in 2000 to 246.5 (95% CI 236.5 to 332.9) per 1000 back pain consultations in 2010. There was also a statistically significant difference in certification between males and females, with males issued more certificates than females. There was a statistically significant difference in certification by age, with those aged 60 years and over being less likely to be issued a certificate compared to all other age groups. CONCLUSIONS Rates of sickness certification for back pain demonstrated a downward trend between 2000 and 2010. While the reasons for this are not transparent, it may be related to changing beliefs around working with back pain.
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Affiliation(s)
- Gwenllian Wynne-Jones
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Kate M Dunn
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
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Ruseckaite R, Collie A, Scheepers M, Brijnath B, Kosny A, Mazza D. Factors associated with sickness certification of injured workers by General Practitioners in Victoria, Australia. BMC Public Health 2016; 16:298. [PMID: 27048576 PMCID: PMC4822251 DOI: 10.1186/s12889-016-2957-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/14/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Work-related injuries resulting in long-term sickness certification can have serious consequences for injured workers, their families, society, compensation schemes, employers and healthcare service providers. The aim of this study was to establish what factors potentially are associated with the type of sickness certification that General Practitioners (GPs) provide to injured workers following work-related injury in Victoria, Australia. METHODS This was a retrospective population-based cohort study was conducted for compensation claims lodged by adults from 2003 to 2010. A logistic regression analysis was performed to assess the impact of various factors on the likelihood that an injured worker would receive an alternate/modified duties (ALT, n = 28,174) vs. Unfit for work (UFW, n = 91,726) certificate from their GP. RESULTS A total of 119,900 claims were analysed. The majority of the injured workers were males, mostly age of 45-54 years. Nearly half of the workers (49.9%) with UFW and 36.9% with ALT certificates had musculoskeletal injuries. The multivariate regression analysis revealed that for most occupations older men (55-64 years) were less likely to receive an ALT certificate, (OR = 0.86, (95%CI, 0.81 - 0.91)). Workers suffering musculoskeletal injuries or occupational diseases were nearly twice or three times at higher odds of receiving an ALT certificate when compared to fractures. Being seen by a GP experienced with workers' compensation increased the odds of receiving ALT certificate (OR = 1.16, (95%CI, 1.11 - 1.20)). Occupation and industry types were also important factors determining the type of certificate issued to the injured worker. CONCLUSIONS This study suggests that specific groups of injured workers (i.e. older age, workers with mental health issues, in rural areas) are less likely to receive ALT certificates.
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Affiliation(s)
- Rasa Ruseckaite
- Institute for Safety, Compensation and Recovery Research, Monash University, 222 Excibition St, Melbourne, Victoria, 3000, Australia.
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, The Alfred Hospital, Melbourne, Victoria, 3004, Australia.
- School of Public Health & Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Alex Collie
- Institute for Safety, Compensation and Recovery Research, Monash University, 222 Excibition St, Melbourne, Victoria, 3000, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, The Alfred Hospital, Melbourne, Victoria, 3004, Australia
| | - Maatje Scheepers
- Institute for Safety, Compensation and Recovery Research, Monash University, 222 Excibition St, Melbourne, Victoria, 3000, Australia
- Monash Injury Outcomes Unit, Monash Injury Research Institute, Monash University, Building 70, Clayton, Victoria, 3800, Australia
| | - Bianca Brijnath
- Department of General Practice, School of Primary Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia
| | - Agnieszka Kosny
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, The Alfred Hospital, Melbourne, Victoria, 3004, Australia
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario, M5G 2E9, Canada
| | - Danielle Mazza
- Department of General Practice, School of Primary Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia
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Mazza D, Brijnath B, Singh N, Kosny A, Ruseckaite R, Collie A. General practitioners and sickness certification for injury in Australia. BMC FAMILY PRACTICE 2015; 16:100. [PMID: 26275607 PMCID: PMC4537596 DOI: 10.1186/s12875-015-0307-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 07/10/2015] [Indexed: 12/02/2022]
Abstract
Background Strong evidence supports an early return to work after injury as a way to improve recovery. In Australia, General Practitioners (GPs) see about 96 % of injured workers, making them the main gatekeepers to workers’ entitlements. Most people with compensable injuries in Australia are certified as “unfit to work” by their GP, with a minority of patients certified for modified work duties. The reasons for this apparent dissonance between evidence and practice remain unexplored. Little is known about the factors that influence GP sickness certification behaviour in Australia. The aim of this study is to describe the factors influencing Australian GPs certification practice through qualitative interviews with four key stakeholders. Methods From September to December 2012, 93 semi-structured interviews were undertaken in Melbourne, Australia. Participants included GPs, injured workers, employers and compensation agents. Data were thematically analysed. Results Five themes describing factors influencing GP certification were identified: 1. Divergent stakeholder views about the GP’s role in facilitating return to work; 2. Communication between the four stakeholder groups; 3. Conflict between the stakeholder groups; 4. Allegations of GPs and injured workers misusing the compensation system and 5. The layout and content of the sickness certificate itself. Conclusion By exploring GP certification practice from the perspectives of four key stakeholders, this study suggests that certification is an administrative and clinical task underpinned by a host of social and systemic factors. The findings highlight opportunities such as practice guideline development and improvements to the sickness certificate itself that may be targeted to improve GP sickness certification behaviour and return to work outcomes in an Australian context. Electronic supplementary material The online version of this article (doi:10.1186/s12875-015-0307-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Danielle Mazza
- Department of General Practice, School of Primary Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, VIC, 3168, Melbourne, Australia.
| | - Bianca Brijnath
- Department of General Practice, School of Primary Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, VIC, 3168, Melbourne, Australia.
| | - Nabita Singh
- Department of General Practice, School of Primary Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, VIC, 3168, Melbourne, Australia.
| | - Agnieszka Kosny
- Institute for Work and Health, University of Toronto, Toronto, Canada.
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia.
| | - Alex Collie
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia. .,Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, Australia.
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