Poster 92 (see Article 1): Rates for Release to Return to Work and for Return to Competitive Employment in 2 Catastrophically Injured Matched Populations: Evidence in Support of the Systematic Care Management Model

Abstract

Objective: To evaluate the efficacy of the Systematic Care Management (SCM) model in returning catastrophically injured workers to competitive employment. Design: To evaluate the efficacy of the SCM model in returning catastrophically injured workers to competitive employment. Design: Cohort study. Setting: A unique nationally distributed systematic care management model involving integrated case management, expert physician direction, and comprehensive clinical and utilization databases. Participants: A random sample of 80 catastrophically injured workers proportionally drawn from a total data base of 1303 patients (traumatic brain injury, n=28; spinal cord injury, n=11; MT, n=26; burns, n=11; amputations, n=3; other, n=1) and a cohort matched sample of 1290 claims from an industry “standard” database of over 60,000 worker compensation claims. Intervention: The SCM model of case management. Main Outcome Measures: Rates for obtained releases for return to work and rates for return to competitive employment of sampled catastrophically injured workers. Results: The SCM model demonstrated a release to return to work rate = 60%; return to competitive employment rate = 41%; return to modified duty rate = 21.3%; and a return to full duty rate = 20%. The industry standard database yielded a release to return to work rate = 13%; a return to competitive employment rate = 8%; a return to modified duty rate = 6.3%; and a return to full duty rate = 1.5%. Conclusions: Systematic care management's model is one that is holistic in its approach to disease management/medical case management. SCM, when applied to catastrophically injured workers, yields an achieved outcome level that exceeds industry standards; for example, 60% of the SCM sample obtained a release to return to work as compared to just 12% of an industry cohort, and 41% of the SCM sample actually returned to competitive employment in contrast to 8% of the industry's sample.