Predictors of non-return to work 2 years post-injury in road traffic crash survivors: Results from the UQ SuPPORT study

Abstract

Non-return to work following road traffic crash 2 Abstract Purpose: Individuals who have sustained an injury from a road traffic crash (RTC) are at increased risk for long lasting health problems and non-return to work (NRTW). Determining the predictors of NRTW is necessary to develop screening tools to identify at-risk individuals and to provide early targeted intervention for successful return to work (RTW). The aim of this study was to identify factors that can predict which individuals will not RTW following minor or moderate injuries sustained from a RTC.Method: Participants were 194 claimants (63.4% female) within a common-law "fault-based" system from the UQ SuPPORT cohort who were working prior to their RTC. Participants were assessed at 6 months on a variety of physical and mental health measures and RTW status was determined at 2 years post-RTC. RTW rate was 78.4%.Results: Univariate predictors of NRTW included being the driver or passenger, having a prior psychiatric diagnosis, high disability level, low mental or physical quality of life, predicted non-recovery, high pain, low function, high expectations of pain persistency, low expectations about RTW, having a psychiatric diagnosis, elevated depression or anxiety. The final multivariable logistic regression model included only two variables: disability level and expectations about RTW. Seventy-five percent of individuals who will not RTW by 2 years can be identified accurately at an early stage, using only these two predictors. Conclusion:The results are promising, because they suggest that having information about two factors, which are easily obtainable, can predict with accuracy those who will require additional support to facilitate RTW. Keywords: Motor Vehicles; Traffic Accidents; Return to Work; Mental Health; HealthNon-return to work following road traffic crash 3 Predictors of non-return to work 2 years post-injury in road traffic crash survivors: results from the UQ SuPPORT studyThe annual cost of road traffic crashes (RTCs) in Australia is estimated at $27 billion 1 and Australia reports spending 3.6% of its gross domestic product on RTCs 2 . The World Health Organization 3 anticipates that RTC injuries will be the third leading cause of disabilityadjusted life years lost (DALYs) by 2020. One of the major factors contributing to these costs is non-return to work (NRTW) following injury. NRTW is also problematic because working is associated with better health, self-esteem and social connectedness 4,5 , as well as improved quality of life and overall longevity 6 .Previous research on return to work (RTW) rates and predictors in RTC cohorts have produced varied results, most likely due to the differences in the nature of injuries in the samples assessed, the variance in severity of injury (mild through to catastrophic), the timeframe for follow-up, the compensation scheme and other sociocultural factors that vary across countries, such as the health care system. Rates of RTW range from 42%-69% at 9 to 12 months post-RTC for more serious inju...

Trajectories of sickness absence after road traffic injury: a Swedish register-based cohort study

“…Moreover, we were not able to assess HRQoL over several time points; hence, we cannot draw conclusions on the change of QoL over the study period. Although this study presented limitations regarding the HRQoL measure, the results concur with previous findings that there is a negative association between the number of SA days and a lower HRQoL 10–12…”

“…Studies have identified a varying rate of individuals who report sickness absence (SA) or have a delayed or failed return to work following RTI, that is, a resumption of SA after a return to work, (ranging from 14% to 42%) 6–9. Persons who have a greater number of SA days and have a delayed or failed return to work report significantly lower self-reported health compared with their counterparts 10–13…”

“…Several cohort studies have investigated factors influencing failed return to work. These studies have identified injury-related factors such as injury severity, disability level and injury type as predictors,10 18–22 with more severe injuries reporting a higher number of SA days following the injury18 and a slower return to work (56% slower),20 compared with those suffering mild injuries. For example, Hours and colleagues18 found that 32% of those suffering severe injuries had not returned to work 1 year after the injury event, compared with 5% of those with mild injuries.…”

“…Regarding injury type, for example, lower extremity injury has been associated with a slower rate of return to work (69% slower) compared with other injuries 20. Other factors that have been associated with failed returning to work include intention to press charges,23 long hospital stay,7 low expectations of return to work,10 occupational status,20 21 chronic pain11 23 and post-traumatic stress disorder 11…”

Impact of interventions on work-related outcomes for individuals with musculoskeletal injuries after road traffic crash: a systematic review protocol

“…government legislation). At the individual level, self-rated health [28], disability level [29], recovery expectations [28, 29], job type [28, 30], and work hours [28] of injured individuals have been associated with return to work rates after a road traffic crash and may also be associated with return to work rates and other work-related outcomes following an intervention.…”