Date post: | 16-Jul-2015 |
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Good practices in the real world
Dr Mary Wyattwww.rtwmatters.org
Multi-Faceted Case Management: Reducing Compensation Costs of Musculoskeletal Work Injuries in Australia.
Iles RA, Wyatt M, Pransky G.
J Occup Rehabil. 2012 Apr 1
Why talk about the study
1. We can be effective in getting people back to work
2. Good quality early intervention is challenging to implement (system barriers)
3. Many policy makers rely on regulations to prevent long term claims
4. Results in cost shifting to other systems rather than improve quality of life
Setting
• Workers comp publicly run system
• Can be a significant cost to employers
• Claims experience influences premium
• Centralised database for Vic comp claims
• Intervention implemented by private company
• Across varying industries – health, manufacturing, aged care etc
• Approx 12 companies, medium to very large
• Approx 800 cases and 2500 matched controls
Intervention
• Day one reporting 24/7
• Case managers coordinating
• Supervisors engaged• Senior managers• Early appropriate
treatment, usual GP or company Dr
• Dealing with the– Fears– Difficult workplace
issues
– Delays in treatment approvals
– The occasional person who didn’t wish to comply with the spirit of RTW
Data from
Intervention companies
Pre-Intervention period Intervention period
Matched controls
Pre-Intervention period Intervention period
Average claim costs
Average days off work
Average medical costs
Across industry
Challenges
• Working against the bureaucracy
• Working against the adversarial approach
• Finding the right people to be case managers
Social contributors and implications
Scheme management
• In Australia, scheme costs managed by reducing ‘tail’ claims
• Limited length of a claim, eg 2 years
• Many shift onto other systems
Policy approaches to RTW
• Focus on process
• Whereas it’s more about people
• Many barriers to effective early intervention
• History of the schemes play a large role
Impact of being out of work• The longer someone is
off work the less likely they are ever to return.
If the person is off work for:
•20 days the chance of ever getting back to work is 70%;
•45 days the chance of ever getting back to work is 50%; •70 days the chance of ever getting back to work is 35%.
AFOEM policy work
Contact details:[email protected]
Link for AFOEM policy work:http://www.racp.edu.au/page/afoem-health-benefits-of-work