OBJECTIVES: The purposes of this study were to: (1) evaluate the effectiveness of changing a Return to Work (RTW) program's focus to one that was "outcome-focused", and (2) to determine which factors collected in the facility's database were most predictive of RTW. METHODS: A total of 13,428 client files were extracted from Millard Health's database which included data on two cohorts of subjects: those in the program before and after the change in focus had been made. This was to determine whether significant improvements in outcomes were achieved. Variables that were hypothesized to be predictive of RTW were selected based on previous published literature. Analyses included ANOVA's, logistic regression analysis and Pearson correlation. RESULTS: Statistically significant improvements in RTW, total temporary disability claims, client satisfaction, efficiency of services and scores on the Perceived Disability Index (PDI), Short Form-36 (SF-36) and Visual Analogue Scale (VAS) for perceived pain were found. Variables that were predictive of RTW included: more efficient services, completion of a worksite visit, having the worker participate in the visit, availability of modified duties from the employer, fewer absences from the program and better scores on the PDI, SF-36 and VAS. The most predictive variable of RTW was sores on the PDI indicating lower levels of perceived disability. CONCLUSIONS: Changing to an outcome-focused program improved various outcomes in this RTW program. Several factors predict the outcome of RTW and these should be considered in treatment planning.
OBJECTIVES: The purposes of this study were to: (1) evaluate the effectiveness of changing a Return to Work (RTW) program's focus to one that was "outcome-focused", and (2) to determine which factors collected in the facility's database were most predictive of RTW. METHODS: A total of 13,428 client files were extracted from Millard Health's database which included data on two cohorts of subjects: those in the program before and after the change in focus had been made. This was to determine whether significant improvements in outcomes were achieved. Variables that were hypothesized to be predictive of RTW were selected based on previous published literature. Analyses included ANOVA's, logistic regression analysis and Pearson correlation. RESULTS: Statistically significant improvements in RTW, total temporary disability claims, client satisfaction, efficiency of services and scores on the Perceived Disability Index (PDI), Short Form-36 (SF-36) and Visual Analogue Scale (VAS) for perceived pain were found. Variables that were predictive of RTW included: more efficient services, completion of a worksite visit, having the worker participate in the visit, availability of modified duties from the employer, fewer absences from the program and better scores on the PDI, SF-36 and VAS. The most predictive variable of RTW was sores on the PDI indicating lower levels of perceived disability. CONCLUSIONS: Changing to an outcome-focused program improved various outcomes in this RTW program. Several factors predict the outcome of RTW and these should be considered in treatment planning.
Authors: Clermont E Dionne; Renée Bourbonnais; Pierre Frémont; Michel Rossignol; Susan R Stock; Isabelle Larocque Journal: CMAJ Date: 2005-06-07 Impact factor: 8.262