title: Integrating health-related quality of life with sickness leave days for return-to-work assessment in traumatic limb injuries.
abstract: OBJECTIVE
  A novel indicator called health-adjusted leave days (HALDs) is proposed. It integrates the opposite level of health-related quality of life (HRQoL) with the sick leave days (LDs) before return-to-work (RTW) to better measure the impact of injuries on occupational health.
  
  
  METHODS
  A total of 1,167 limb injuries were consecutively recruited in a teaching hospital from January to December 2009. The number of LDs was calculated between the date of injury and the first episode of RTW. Each subject was repeatedly assessed with EuroQol instrument (EQ-5D) before RTW. The HRQoL index is defined as 1 minus the EQ-5D utility and re-scaled to 0-1 range to reflect the impact of injuries. The expected HALD of each group is calculated by integrating the product of the proportion of non-RTW function and the mean HRQoL index function over the days followed up to 2 years for the group. We compared the expected HALDs between subgroups according to various demographic characteristics and consequences of injury.
  
  
  RESULTS
  Older and female workers tended to have longer LDs than men and younger workers, with an increase in percentage change of 16.0 or 139.5 %, respectively. After adjusting for HRQoL index, the percentages for HALDs were changed to 28.7 or 186.6 %, respectively. The percentages for the less-educated workers and blue collar workers were 185.7 and 155.8 %. The expected HALDs showed statistical significant differences in all subgroup analyses.
  
  
  CONCLUSIONS
  We believed that the proposed HALD could better measure the impact of injuries and is potentially useful for the clinical decision and industrial policy-making with respect to the assessment of the importance of limb injury due to a worker's sick leaves.
authors: Department of Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan.
authors: Wen-Hsuan
authors: WH
authors: Hou
authors: Huey-Wen
authors: HW
authors: Liang
authors: Ching-Lin
authors: CL
authors: Hsieh
authors: Ching-Fan
authors: CF
authors: Sheu
authors: Jing-Shiang
authors: JS
authors: Hwang
authors: Hung-Yi
authors: HY
authors: Chuang
mesh_terms: D000328:Adult; D000367:Age Factors; D001134:Arm Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007869:Leg Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases; D016272:Occupational Health; D011788:Quality of Life; D062707:Return to Work; D012737:Sex Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D012917:Social Adjustment; D013997:Time Factors; D055815:Young Adult
references: J Trauma. 2011 Aug;71(2):425-34
references: 21045746
references: J Trauma. 2007 Jan;62(1):133-41
references: 17215744
references: Stat Med. 1999 Jul 15;18(13):1627-40
references: 10407234
references: Arch Phys Med Rehabil. 2013 Apr;94(4):703-10
references: 23206657
references: Qual Life Res. 2003 Aug;12(5):503-17
references: 13677495
references: Scand J Work Environ Health. 2006 Apr;32(2):91-8
references: 16680379
references: J Toxicol Environ Health A. 2005 Sep;68(17-18):1485-96
references: 16076761
references: Health Policy. 1990 Dec;16(3):199-208
references: 10109801
references: Int J Epidemiol. 1972 Winter;1(4):361-8
references: 4669084
references: Ann Trop Med Parasitol. 2006 Jul-Sep;100(5-6):481-99
references: 16899150
references: Am J Public Health. 1987 Mar;77(3):329-34
references: 3812840
references: Scand J Work Environ Health. 2012 Jan;38(1):70-7
references: 21912828
references: Qual Life Res. 2004 Feb;13(1):1-10; discussion 11-4
references: 15058782
references: Epidemiol Rev. 2003;25:3-19
references: 12923986
references: Accid Anal Prev. 2006 Sep;38(5):961-8
references: 16712760
references: J Trauma. 2006 Sep;61(3):688-94
references: 16967009
references: J Trauma. 2007 Feb;62(2):471-81
references: 17297338
references: Am J Epidemiol. 2010 Apr 15;171(8):917-23
references: 20237152
references: Am J Ind Med. 2005 Feb;47(2):104-12
references: 15662646
references: J Rehabil Med. 2008 Jun;40(6):440-5
references: 18509558
references: J Formos Med Assoc. 2007 Dec;106(12):1023-31
references: 18194908
references: Am J Public Health. 1998 Nov;88(11):1630-7
references: 9807528
references: J Trauma. 2009 Oct;67(4):883-90
references: 19820601
references: Am J Public Health. 2010 Jan;100(1):165-70
references: 19910346
references: BMJ. 2002 Jun 15;324(7351):1417
references: 12065262
references: Inj Prev. 2004 Oct;10(5):314-9
references: 15470014
references: Med Care. 2005 Mar;43(3):221-8
references: 15725978
references: Lancet. 2002 Nov 2;360(9343):1347-60
references: 12423980
references: Occup Environ Med. 1995 Feb;52(2):138-42
references: 7757168
references: Value Health. 2008 Dec;11(7):1102-9
references: 18489497
references: Stroke. 2010 Apr;41(4):739-44
references: 20150543
references: Qual Life Res. 2001;10(7):621-35
references: 11822795
references: Med Care. 1997 Nov;35(11):1095-108
references: 9366889
references: Scand J Work Environ Health. 2012 Sep;38(5):456-66
references: 22388635