Work Incapacity and Treatment Costs After Severe Accidents: Standard Versus Intensive Case Management in a 6-Year Randomized Controlled Trial
| Autor: | Peter Andermatt, Benno L. Tobler, Dieter Spinnler, S. M. Scholz |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male 030506 rehabilitation medicine.medical_specialty Return to work medicine.medical_treatment Work Capacity Evaluation Poison control Article Occupational safety and health Case management law.invention Insurance 03 medical and health sciences 0302 clinical medicine Occupational Therapy Randomized controlled trial law Injury prevention Health care medicine Humans Musculoskeletal Diseases Prospective Studies 030212 general & internal medicine Actuarial science Rehabilitation business.industry Treatment costs Human factors and ergonomics Rehabilitation Vocational Middle Aged Work (electrical) Accident Accidents Physical therapy Female 0305 other medical science business |
| Zdroj: | Journal of Occupational Rehabilitation |
| ISSN: | 1573-3688 1053-0487 |
| Popis: | Purpose Case management is widely accepted as an effective method to support medical rehabilitation and vocational reintegration of accident victims with musculoskeletal injuries. This study investigates whether more intensive case management improves outcomes such as work incapacity and treatment costs for severely injured patients. Methods 8,050 patients were randomly allocated either to standard case management (SCM, administered by claims specialists) or intensive case management (ICM, administered by case managers). These study groups differ mainly by caseload, which was approximately 100 cases in SCM and 35 in ICM. The setting is equivalent to a prospective randomized controlled trial. A 6-year follow-up period was chosen in order to encompass both short-term insurance benefits and permanent disability costs. All data were extracted from administrative insurance databases. Results Average work incapacity over the 6-year follow-up, including contributions from daily allowances and permanent losses from disability, was slightly but insignificantly higher under ICM than under SCM (21.6 vs. 21.3 % of pre-accident work capacity). Remaining work incapacity after 6 years of follow-up showed no difference between ICM and SCM (8.9 vs. 8.8 % of pre-accident work incapacity). Treatment costs were 43,500 Swiss Francs (CHF) in ICM compared to 39,800 in SCM (+9.4 %, p = 0.01). The number of care providers involved in ICM was 10.5 compared to 10.0 in ICM (+5.0 %, p |
| Databáze: | OpenAIRE |
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