Prediction of Return to Work Outcomes Under an Injured Worker Case Management Program

Abstract

Many factors affect worker return to work (RTW) after occupational injury, among which effective case management strategies play a particularly vital role in prompting workers for a successful RTW. Objectives This study aimed at predicting the RTW outcome and optimizing the intervention scheme of a case management program initiated in China. A retrospective cohort was formed with 523 injured workers treated at a rehabilitation center for work injuries in southern China. The social demographic information, medical data and intervention process were extracted from the medical records of the rehabilitation center. A Cox Regression Model was used to examine the predictors of RTW case management. 261 patients (77.9%) out of the 335 valid subjects successfully returned to work after median absence duration of 36.0 days. A computer skills training program was a positive factor for RTW outcomes (hazard ratio 1.5, P < 0.001). Psychological counseling was possibly an important measure to improve RTW with a hazard ratio of 3.4 (95% CI 0.94-16, P > 0.05). Disability adjustment accommodations did not specifically benefit RTW. Education level, family's attitude to RTW, personal perceptions about social support for RTW, and injury severity were significantly associated with outcomes of RTW. It was implied that RTW intervention should be focused on a specific skill reconstruction and training which was presumably related with labor market needs. However, tailored psychological counseling and disability adjustment activity should not be ignored in RTW.