According to this month’s issue of the American Public Health Association journal, Medical Care, studies of occupational healthcare in Washington indicate that improving medical care for injured workers significantly decreases missed work time. The study was conducted by Dr Thomas Wickizer of Ohio State University, College of Public Health, and Dr. Gary Franklin, medical director at Washington State’s Department of Labor & Industries (L&I).
“Work-related disability is a major public health problem that’s largely overlooked in the U.S.,” Dr. Franklin of L&I said. “This study shows that using occupational health best practices when treating injured workers can have an important effect on their recovery.”
In 2008, L&I began to collaborate with physicians in both Washington and throughout the U.S., University of Washington medical researchers, and business leaders and labor advocates to assess best practices for helping workers recover during the first 12 weeks following a work-related injury. L&I’s Centers of Occupational Health and Education (COHE) were the direct outcome of this project; these organizations function as community-based centers that promote the most effective procedures and treatments of injured workers.
Specifically, these practices emphasize the safe, healthful recovering of injured workers and their return to full capacity and employment in the workplace. Such “best practices” include quickly filing a workers’ compensation claim with L&I, directly contacting the employer to discuss the worker’s ability to resume their job (or some lighter tasks in the workplace), and frequently evaluating a worker’s ability to perform tasks and activities at work.
L&I provides monetary incentives and administrative support to COHE healthcare providers to help them put injured workers back to work as soon as possible. Health services coordinators are central to the success of this process: these individuals work with COHEs and report to healthcare delivery teams, supporting community-wide integration of medical care.
This undertaking, and the enhanced integration of care by way of best practices and incentives, has emerged as an early prototype of what many imagine could be a more “accountable-care” concept within national health care reform.
The study involved seven workers compensation researchers from L&I, the Ohio State University’s College of Public Health, and the University of Washington’s Department of Environmental and Occupational Health Sciences. Together, this team examined and evaluated 105,000 + workers’ compensation claims from 2001 to 2007, including both COHE and non-COHE-related claims. Findings show that injured workers who received treatment from healthcare providers following COHE best practices had 20% fewer “disability days” compared to other injured workers receiving treatment, as well as a $510 drop in total medical and disability costs per claim. One of the most promising figures related to back strain: workers with back injuries showed a 30% drop in disability days. In his report, Dr. Franklin stated: “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.”
At the moment, four COHE sites work with 2,000 providers and hundreds of workplaces, providing treatment to nearly one-third of injured workers in Washington. Figures from the study brought about new legislation this year that will make COHEs more accessible, expanding access to all injured workers in Washington by 2015.