Less coordination of care was found to be a factor in injured workers relying on “prolonged” post-injury physical rehabilitation, according to a study released Wednesday by the Workers Compensation Research Institute.
According to WCRI, physical services are often used to treat workers with low back pain and other musculoskeletal injuries, and in recent years there has been an increase in the frequency of claims receiving physical medicine. After adjusting for the differences in severity and other factors, WCRI found that claims with increased use of physical medicine had higher total medical costs, higher compensation payments, and a longer duration of temporary disability.
Most treatment guidelines for low back pain address initial physical medical care, leaving subsequent care ordered by providers over an extended period of time at the discretion of the employer or payers, according to the study, which pointed to several factors that increased the likelihood of expanded services.
The most important factors are related to the involvement of multiple providers in care, suggesting that better coordination among providers can result in fewer visits, according to WCRI.
Severity indicators also predict increased use of physical medicine. For example, claims with nerve involvement were 2.4 times more likely to have increased physical medication use compared to similar cases without neuropathic conditions. Workers with at least one comorbidity were also 1
.8 times more likely to have extended physical medicine visits, according to WCRI.Practice patterns also made a difference in predicting the likelihood of having expanded use of physical medicine, as the WCRI found that if a claim already had 15 or more visits in the first six weeks of physical medicine care, the claim was twice as likely to had extended physical medicine drug use compared to a claim with fewer than 15 visits within six weeks.
The WCRI also found that a worker’s characteristics had a “small effect” on the likelihood of having long-term use of physical medicine. For example, younger male workers were less likely to have long-term use of physical medicine while workers aged 55 years or older had an increased likelihood of long-term use of physical medicine.
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