An organizational case study of the case manager's role in a client's return-to-work programme in Australia.

The purpose of this study was to examine the case manager's role in a return-to-work programme in Sydney, Australia. The investigators examined the case manager's role assumed by occupational therapists, physiotherapists, psychologists and rehabilitation counsellors when providing occupational rehabilitation services. Files of closed cases (n=172) were examined to investigate the relationship between the case manager's profession and return-to-work outcomes. It was found that the provider of occupational rehabilitation examined in this study achieved above-average return-to-work rates (83%), with no significant difference between case managers. There was, however, a significant relationship between the client's type of injury and the case manager (p<0.001), and case length was significantly different between case managers (p=0.004). The occupational therapist had the largest case management load (43%), followed by the rehabilitation counsellor (23%). There were trends (0.05<p<0.1) between the case manager's profession and return to the same employer, and return to pre-injury, modified or new duties. The provider allocated cases on the basis of professional expertise and skill, which proved to be successful. The provision of workplace-based occupational rehabilitation services combined with case management provides a comprehensive and attractive package to employers and other referrers. Further research is required to investigate factors associated with case management that improve return-to-work outcomes.