title: Compensation benefits in a population-based cohort of men and women on long-term disability after musculoskeletal injuries: costs, course, predictors.
abstract: OBJECTIVE
  The aim of this study is to assess costs, duration and predictors of prolonged compensation benefits by gender in a population characterised by long-term compensation benefits for traumatic or non-traumatic musculoskeletal injuries (MSIs).
  
  
  METHODS
  This study examined 3 years of data from a register-based provincial cohort including all new allowed long-term claims (≥3 months of wage replacement benefits) related to neck/shoulder/back/trunk/upper-limb MSIs in Quebec, Canada, from 2001 to 2003 (13,073 men and 9032 women). Main outcomes were compensation duration and costs. Analyses were carried out separately for men and women to investigate gender differences. An extended Cox model with Heaviside functions of time was used to account for covariates with time-varying effects.
  
  
  RESULTS
  Male workers experienced a longer compensation benefit duration and higher median costs. At the end of follow-up, 3 years postinjury, 12.3% of men and 7.3% of women were still receiving compensation benefits. Effects of certain predictors (e.g., income, injury site or industry) differed markedly between men and women. Age and claim history had time-varying effects in the men's and women's models, respectively.
  
  
  CONCLUSIONS
  Knowing costs, duration and predictors of long-term compensation claims by gender can help employers, decision makers and rehabilitation specialists to identify at-risk workers and industries to engage them in early intervention and prevention programmes. Tailoring parts of long-term disability prevention and management efforts to men's and women's specific needs, barriers and vulnerable subgroups, could reduce time on benefits among both male and female long-term claimants.
authors.affiliation: Department of Industrial Relations, University of Quebec in Outaouais, Gatineau, Québec, Canada University of Montreal Public Health Research Institute, Montreal, Québec, Canada Department of Social and Preventive Medicine, University of Montreal, Québec, Canada.
authors.forename: Valérie
authors.initials: V
authors.lastname: Lederer
authors.affiliation: University of Montreal Public Health Research Institute, Montreal, Québec, Canada Department of Social and Preventive Medicine, University of Montreal, Québec, Canada.
authors.forename: Michèle
authors.initials: M
authors.lastname: Rivard
mesh_terms: D000062:Accidents, Occupational; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007182:Income; D007221:Industry; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000191:economics; D009784:Occupational Diseases / Q000191:economics; D060051:Occupational Injuries / Q000191:economics; D016016:Proportional Hazards Models; D011792:Quebec; D062707:Return to Work; D012737:Sex Factors; D013997:Time Factors; D014942:Workers' Compensation / Q000191:economics; D055815:Young Adult
keywords: Compensation; Long-term; Longitudinal study; Register-based study