As reported in the December issue of Medical Care, the American Public Health Association journal, a comprehensive study of occupational healthcare shows that improvements in medical care for injured workers has reduced missed days at work in Washington. The study was led by Dr Wickizer of Ohio State University, College of Public Health, and Dr. Franklin, medical director of Washington State’s L&I Department of Labor & Industries.
In a press release, L&I’s Dr. Franklin stated that “Work-related disability is a major public health problem that’s largely overlooked in the U.S. This study shows that using occupational health best practices when treating injured workers can have an important effect on their recovery.”
Back in 2008, L&I started working with doctors in Washington and across the U.S., as well as University of Washington medical researchers, community business leaders and labor advocates, to evaluate best practices for enhancing worker recovery during the 12-week period immediately after a work-related injury. The Centers of Occupational Health and Education (COHE) at L&I were created out of this project. These organizations support various community-based centers to advance the most effective practices and treatments of injured workers.
In particular, these practices are concerned with promoting the safe, healthy recovery of injured workers and facilitating a return to full capacity at work. Among the “best practices” reported in the study were:
- immediately filing a workers’ compensation claim with L&I
- directly contacting the employer or manager to talk about the employee’s ability to resume his or her usual work (or a lighter task in the meanwhile)
- regularly monitoring and assessing the worker’s ability to perform work tasks and activities.
L&I even offers financial incentives and administrative support to healthcare providers under COHE to help them in placing injured workers back in the line of duty as soon as it’s safe to do so. Health services coordinators are essential to the program’s success: these coordinators work with COHEs and report to healthcare delivery teams, collaborating with and advancing a community-wide integration of medical care for injured workers.
This effort, along with the enhanced integration of healthcare through best practices and incentives, has become an early model for what could be an “accountable-care” concept in the national health care reform movement.
Details of the Study
The team assembled by Dr Wickizer and L&I assessed more than 100,000 workers’ compensation claims from 2001 through 2007, including COHE and non-COHE-related claims alike. Results indicated that injured workers who received treatment from healthcare providers adhering to COHE best practices suffered 20% fewer “disability days” when compared to other injured workers receiving treatment; there was also a $500 decrease in total medical and disability costs per claim. One of the most hopeful statistics emerged in the area of back strain: workers suffering back injuries had a 30% drop in disability days. Dr. Franklin’s report commented as follows: “We’re especially encouraged that the outcomes for workers with low-back strain were significantly better. Lower-back strain is a costly and common disabling condition in workers’ compensation.”
Currently, four COHE sites are collaborating with 2,000 providers, hundreds of workplaces and thousands of Washington workers, administering medical care to almost a third of injured workers in the state. Data and related assessments from the study helped push through new legislation this year that increased the accessibility to COHEs, and will broaden access to all injured workers in Washington by 2015.
