Does medical certification of workers with injuries influence patterns of health service use?
BACKGROUND
Among workers with injuries who seek compensation, a general practitioner (GP) usually plays an important role in a person's return to work (RTW) by advising if the worker is unfit for work (UFW), is able to work on alternate (ALT) duties or is fit for work and also providing referrals to other health service providers.


OBJECTIVE
To examine patterns of health service utilization (HSU) in workers with injuries by condition and type of certificate issued by GP.


METHODS
Zero-inflated negative binomial and logistic regressions were conducted for major healthcare services accessed over the 12-month period post-initial medical examination. Services included GP consultations, pharmacy, physiotherapy, occupational rehabilitation and psychology.


RESULTS
The average number of physiotherapy services was greater in workers with musculoskeletal disorders, back pain and fractures. In contrast, the median number of psychological services was greater in mental health conditions (MHC). Workers with ALT certificates were more likely to use GPs, pharmacy and physiotherapy services.


CONCLUSIONS
HSU in the 12 months post-initial medical certification varied substantially according to the worker's condition, certificate type, age, gender and residential location. Understanding these factors can facilitate more appropriate resource allocation; strategic thinking on optimal use of particular health services and enables better targeting of particular provider groups for more education on the health benefits of RTW.
Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.|Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, The Alfred Hospital, Melbourne, VIC, Australia.
Rasa
R
Ruseckaite
Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.
Alex
A
Collie
Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.|Monash Injury Outcomes Unit, Monash Injury Research Institute, Monash University, Clayton, VIC, Australia.
Khic-Houy
KH
Prang
Department of General Practice, School of Primary Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, VIC, Australia.|Faculty of Health Sciences, School of Occupational Therapy and Social Fork, Curtin University, Bentley, WA, Australia.
Bianca
B
Brijnath
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, The Alfred Hospital, Melbourne, VIC, Australia.|Institute for Work and Health, Toronto, ON, Canada.
Agnieszka
A
Kosny
Department of General Practice, School of Primary Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, VIC, Australia.
Danielle
D
Mazza
D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D016010:Binomial Distribution; D002568:Certification; D005260:Female; D058005:General Practitioners; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D060051:Occupational Injuries / Q000453:epidemiology / Q000628:therapy*; D062707:Return to Work; D014938:Work Capacity Evaluation; D014942:Workers' Compensation / Q000706:statistics & numerical data*; D055815:Young Adult
Injury; mental health; return-to-work; workers’ compensation