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					                             UBC CENTRE FOR
                             HEALTH SERVICES AND                                                                                RESEARCH
                             POLICY RESEARCH                                                                                   BRIEFS
                             Return-to-work outcomes following surgery for work-
                             related knee injury
                             The effect of sociodemographic and work factors

                             Key Messages                                                   Based on research presented in
                               •  Musculoskeletal injuries are common,                      Fan JK, McLeod CG, Koehoorn M.  Sociodemographic, 
                                  troublesome, and costly, and can result in                clinical, and work characteristics associated with return-
                                  significant time loss from work and health care 
                                                                                            to-work  outcomes  following  surgery  for  work-related 
                                  costs.
                               •  This study showed that women, workers of low              knee injury.  Scandinavian Journal of Work, Environment 
                                  socio-economic status, and those in physically            and Health. 2010;36(4):332–338.
                                  demanding jobs are less likely to experience full 
                                  return-to-work after knee surgery following an 
                                  occupational injury.
                               •  Sociodemographic and work characteristics                 Return to work after surgery
                                  influence disability outcomes, so they should be        A number of previous studies have examined factors that 
                                  considered as determinants of worker health in          influence the RTW trajectory following musculoskeletal 
                                  return-to-work programs and policies.                   injury.    Demographic,  work,  social,  and  clinical  factors 
                                                                                          have been shown to influence injured workers’ RTW out-
                             Musculoskeletal injuries and worker health                   comes.  Few studies have looked specifically at outcomes 
                             Although the rate of  work-related injuries in Canada has  related to knee surgery.
                             decreased in the past decade, musculoskeletal injuries re-
                             main a serious, and costly, problem for workers and for  Previous studies have used a range of measures to define 
                             the healthcare system.  Conditions affecting the muscu- RTW.    Most  studies  have  focused  on  measures  such  as 
                             loskeletal system can be chronic and recurrent, and often  time  to  RTW  or  compensation  costs,  while  only  a  few 
        This document is
   protected by copyright.
                             result in long-term disability and increased demands on  have investigated types of RTW such as return to full or 
    It may be distributed    the healthcare system.  In British Columbia, musculosk- partial duties.  Since the type of RTW can have a major 
      for educational and    eletal injuries accounted for almost 60% of all lost-time  impact on a variety of stakeholders (including workers, 
     non-commercial use      claims and disability days and costs.  Of all work injuries  employers, and compensation boards), it is useful to con-
  provided the UBC Cen-      requiring  surgery,  procedures  involving  the  knee  me- sider a range of RTW trajectories.
   tre for Health Services   niscus  have  remained  the  most  common  in  BC.    This 
   and Policy Research is    study examined the association between return-to-work 
                 credited.   (RTW)  outcomes  and  sociodemographic,  clinical,  and                                                      Continued »
                             work characteristics among a group of injured workers 
       The work was sup-
                             who underwent knee surgery.
   ported by the CHSPR-
    WorkSafeBC Partner-
   ship, WorkSafeBC, and
  the Canadian Institutes
      of Health Research.




C H S P R .U B C .C A        Advancing world-class health services and policy research,
                             training and data resources on issues that matter to Canadians.
UBC CENTRE FOR HE A LTH S E RV I C E S A N D P O L I C Y R E S E A R C H                                                        R E S E ARCH BRIEFS



Defining a range of return-to-work outcomes                                Workers in physically demanding jobs were less likely to have  full 
The objective of this study was to identify the sociodemographic,          return-to-work.  When compared to workers in management and 
clinical, and work factors related to RTW outcomes following sur-          professional occupations, healthcare workers were more likely to 
gery for an accepted workers’ compensation claim for a knee injury.        have partial RTW compared to full RTW.  Workers in the trades, 
The study examined four categories of RTW outcomes: partial, full,         in primary industry, and in processing/manufacturing were more 
unspecified, or non-RTW  (unspecified RTW was defined when                 likely to have non-RTW compared to full RTW.  Other studies ex-
a RTW date was found, but the study team could not definitively            amining  RTW outcomes among different  types  of jobs  have  not 
assess it as partial or full).  The study examined health data on 1394     shown a consistent relationship between physically demanding oc-
workers  who  underwent  meniscal  knee  surgery  between  2001-           cupations and RTW outcomes.
2005.  
                                                                           Implications
What influences return-to-work outcomes?                                   The results of our study show that clinical and surgical character-
Although 86% of workers in this study did return to work follow-                                                                                        
                                                                           istics  are  not  the  only  factors  that  influence  disability  outcomes. 
ing knee surgery, a number of factors influenced RTW status.  The          Gender, income level, and type of occupation may also be impor-
analysis showed that workers with lower annual incomes are more            tant factors.  Thus, return-to-work programs should consider these 
likely  to  experience  partial,  unspecified  or  non-RTW  outcomes. 
                                                                           broader determinants of health.  This may enable injured workers 
This finding is consistent with other studies that have also shown         to safely return to work in a more timely manner. 
an inverse relationship between income and work disability.

The analysis also found that women were more likely to have partial 
or non-RTW compared to full RTW, and that they took approxi-
mately 2.5 weeks longer to return to work than men.  Other stud-
ies examining the association between gender and RTW have not 
found a consistent trend.




C HS P R .U B C .C A            Advancing world-class health services and policy research,
                                training and data resources on issues that matter to Canadians.

				
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