Rehabilitation of compensable workplace injuries: effective payment models for quality vocational rehabilitation outcomes in a changing social landscape

Matthews, Lynda R.; Hanley, Francine; Lewis, Virginia; Howe, Caroline

doi:10.3109/09638288.2014.933897

Cited by 4 publications

(4 citation statements)

References 30 publications

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“…Even though this study sheds light on important concerns regarding PT care for injured workers, the influence of WCBs’ policies on PT care has yet to be comprehensively studied [54]. New studies could thus aim to further explore and understand the influence of inter-organisational interactions on the provision of PT care for injured workers, using the concept of clinical governance, for example [49].…”

Section: Discussionmentioning

confidence: 99%

Physiotherapy for injured workers in Canada: are insurers’ and clinics’ policies threatening good quality and equity of care? Results of a qualitative study

Hudon

Hunt

Feldman

2018

BMC Health Serv Res

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BackgroundIn recent years, significant efforts have been made to improve the provision of care for compensated injured workers internationally. However, despite increasing efforts at implementing best practices in this field, some studies show that policies overseeing the organisation of care for injured workers can have perverse influences on healthcare providers’ practices and can prevent workers from receiving the best care possible. The influence of these policies on physiotherapists’ practices has yet to be investigated. Our objectives were thus to explore the influence of 1) workers’ compensation boards’ and 2) physiotherapy clinics’ policies on the care physiotherapists provide to workers with musculoskeletal injuries in three large Canadian provinces.MethodsThe Interpretive Description framework, a qualitative methodological approach, guided this inquiry. Forty participants (30 physiotherapists and 10 leaders and administrators from physiotherapy professional groups and workers’ compensation boards) were recruited in British Columbia, Ontario and Quebec to participate in an in-depth interview. Inductive analysis was conducted using constant comparative techniques.ResultsNarratives from participants show that policies of workers’ compensation boards and individual physiotherapy clinics have significant impacts on physiotherapists’ clinical practices. Policies found at both levels often place physiotherapists in uncomfortable positions where they cannot always do what they believe to be best for their patients. Because of these policies, treatments provided to compensated injured workers markedly differ from those provided to other patients receiving physiotherapy care at the same clinic. Workers’ compensation board policies such as reimbursement rates, end points for treatment and communication mechanisms, and clinic policies such as physiotherapists’ remuneration schemes and restrictions on the choice of professionals had negative influences on care. Policies that were viewed as positive were board policies that recognize, promote and support physiotherapists’ duties and clinics that provide organisational support for administrative tasks.ConclusionIn Canada, workers’ compensation play a significant role in financing physiotherapy care for people injured at work. Despite the best intentions in promoting evidence-based guidelines and procedures regarding rehabilitation care for injured workers, complex policy factors currently limit the application of these recommendations in practice. Research that targets these policies could contribute to significant changes in clinical settings.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3491-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Physiotherapy for injured workers in Canada: are insurers’ and clinics’ policies threatening good quality and equity of care? Results of a qualitative study

Hudon

Hunt

Feldman

2018

BMC Health Serv Res

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“… 21 Additionally, changing the reimbursement models by linking payment to outcomes has been proposed to be a potential way to decrease costs and improve return to work timing. 22 Interestingly, a worker’s desire or expectation to return to work may play a larger role in their recovery than the actual rehabilitation services, 23 suggesting that patient expectations should be considered when developing a rehabilitation plan, which may help reduce utilization and costs.…”

Section: Discussionmentioning

confidence: 99%

“…Defensive medicine by US orthopedic trauma surgeons has been estimated to be roughly US $94 000 annually per surgeon. 22 When considering all subspecialties in the field of orthopedic surgery, the costs may be even higher, with an estimated 24% of tests being performed for defensive measures, resulting in US $100 000 of additional health-care costs per year, per surgeon. 24 The mere act of defending a law suit can generate huge fees, with 30% of litigation costs being legal fees.…”

Section: Discussionmentioning

confidence: 99%

A Review of a Workers’ Compensation Database 2003 to 2013: Patient Factors Influencing Return to Work and Cumulative Financial Claims After Rotator Cuff Repair in Geriatric Workers’ Compensation Cases

Shields

Thirukumaran

Noyes

et al. 2017

Geriatr Orthop Surg Rehabil

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Background:Workers’ compensation status is associated with poor outcomes after rotator cuff repair surgery. The purpose of this study was to analyze a database of geriatric workers’ compensation patients after surgical repair of the rotator cuff and identify both medical and nonmedical patient factors that influence the time it takes for them to return to work at full duty, including a comparison of arthroscopic and open techniques.Methods:An all workers’ compensation database was queried for rotator cuff claims that were surgically managed using arthroscopic, open, or both approaches from 2003 to 2013 in patients aged ≥60. Primary outcomes were the number of days for return to full work (RTW) following surgery and the total reimbursement for health care. Multivariate analysis was performed, and data are presented as average ± standard deviation.Results:The database yielded 1903 claims for surgically treated rotator cuff conditions (arthroscopic n = 935; open n = 926; both n = 42). In multivariate RTW analyses, we did not find a significant difference between groups (RTW in days was 153 ± 134 for arthroscopy [P = .81], 160 ± 160 for open [Ref], and 140 ± 82 days for both [P = .75]). However, multivariate analysis of reimbursement claims found arthroscopic surgery claims to be 13% higher compared to claims for open surgery only (US $29 986 ± 16 259 for arthroscopy vs US $26 495 ± 13 186 for open, P < .001). Patients aged ≥65 had more medical expenses than patients aged 60 to 64 (P = .03). Potentially modifiable variables that significantly prolonged RTW timing and higher health-care claims included need for vocational rehabilitation services and filing of a legal suit.Conclusions:Return to full-duty work in geriatric workers’ compensation patients after rotator cuff repair takes about 5 months regardless of surgical approach and costs significantly more in patients aged ≥65. Arthroscopic repairs generated 13% more cumulative health-care costs than open surgery alone. More efficient vocational rehabilitation services and minimizing legal suits may help get patients back to work sooner and reduce overall costs.

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“…Hal tersebut selaras dengan pendapat (Rosy Nur, 2022) yang menjelaskan tahapan intervensi terapi menghardik meliputi menjelaskan cara menghardik, memperagakan cara menghardik, meminta pasien memperagakan ulang cara menghardik, memantau menerapkan cara ini, menguatkan pada perilaku pasien. Berdasarkan tiga macam model pelayanan rehabilitasi sosial yaitu Intsitusional Based Rehabilitatuin (IBR), Extrainstitutional Based Rehabilitation (EBR), dan Comunity Based Rehabilitation (CBR), Rumah Singgah Dosaraso termasuk dalam pelayanan rehabilitasi sosial dengan model IBR yaitu bentuk pelayanan rehabilitasi sosial dimana para penyandang masalah sosial ditempatkan disuatu institusi atau lembaga tertentu dengan sarana prasarana yang mendukung untuk diberi pelayanan rehabilitasi sosial (Matthews et al, 2015).…”

Section: Pembahasanunclassified

Penerapan Terapi Menghardik Halusinasi Terhadap Pasien Eks Psikotik dalam Rehabilitasi Sosial

Yulia Saputri,

Muslihudin

2023

JBK

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Along with the rapid development, modernization and industrialization efforts, social changes and problems are growing. So that people who are unable to make adjustments, can experience mental turmoil, mental disorders and even mental disorders called psychotics. Therefore, this study aims to describe the application of hallucinatory rebuke therapy in the rehabilitation process of ex-psychotic patients at the Dosarso Shelter House, Kebumen. This research method uses a type of qualitative research with a case study approach. This study had 4 subjects, namely 2 ex-psychotic patients who were still experiencing hallucinations, 1 nurse and 1 administrator who worked at the Dosaraso Shelter in Kebumen. The results of this research show that rebuke therapy at the Dosaraso Shelter Home in Kebumen is carried out in groups and individually. The social rehabilitation service model provided by Dosaraso includes the Institutional Based Rehabilitation (IBR) service model. Then the type of psychotic experienced by TS patients is schizophrenic functional psychotic with auditory and visual hallucinations, while patient D is paranoid functional psychotic with auditory hallucinations. This rebuke therapy is carried out through several stages, namely starting from preparing the place, explaining the therapy, agreeing to the therapy, time contract, implementation, and finally asking the patient's feelings. This research can also help counselors in carrying out therapeutic steps for ex-psychotic patients so that it is very helpful in overcoming social problems in society.

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Rehabilitation of compensable workplace injuries: effective payment models for quality vocational rehabilitation outcomes in a changing social landscape

Cited by 4 publications

References 30 publications

Physiotherapy for injured workers in Canada: are insurers’ and clinics’ policies threatening good quality and equity of care? Results of a qualitative study

Physiotherapy for injured workers in Canada: are insurers’ and clinics’ policies threatening good quality and equity of care? Results of a qualitative study

A Review of a Workers’ Compensation Database 2003 to 2013: Patient Factors Influencing Return to Work and Cumulative Financial Claims After Rotator Cuff Repair in Geriatric Workers’ Compensation Cases

Penerapan Terapi Menghardik Halusinasi Terhadap Pasien Eks Psikotik dalam Rehabilitasi Sosial

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