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Does the Economy Affect Functional Restoration Outcomes for Patients with Chronic Disabling Occupational Musculoskeletal Disorders?

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Abstract

Purpose To determine how the economy affects psychosocial and socioeconomic treatment outcomes in a cohort of chronic disabling occupational musculoskeletal disorder (CDOMD) patients who completed a functional restoration program (FRP). Methods A cohort of 969 CDOMD patients with active workers’ compensation claims completed an FRP (a medically-supervised, quantitatively-directed exercise progression program, with multi-modal disability management). A good economy (GE) group (n = 532) was released to work during a low unemployment period (2005–2007), and a poor economy (PE) group (n = 437) was released during a higher unemployment period (2008–2010). Patients were evaluated upon admission for demographic and psychosocial variables, and were reassessed at discharge. Socioeconomic outcomes, including work return and work retention 1 year post-discharge, were collected. Results Some significant differences in psychosocial self-report data were found, but most of the effect sizes were small, so caution should be made when interpreting the data. Compared to the PE group, the GE group reported more depressive symptoms and disability at admission, but demonstrated a larger decrease in depressive symptoms and disability and increase in self-reported quality of life at discharge. The PE group had lower rates of work return and retention 1-year after discharge, even after controlling for other factors such as length of disability and admission work status. Conclusions CDOMD patients who completed an FRP in a PE year were less likely to return to, or retain, work 1-year after discharge, demonstrating that a PE can be an additional barrier to post-discharge work outcomes. A difference in State unemployment rates of <3 % (7 vs. 5 %) had a disproportionate effect on patients’ failure to return to (19 vs. 6 %) or retain (28 vs. 15 %) work.

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Conflict of interest

Meredith M. Hartzell, Tom G. Mayer, Randy Neblett, Robert J. Gatchel, and Dennis Marquardt declare that they have no conflict of interest.

Ethical standard

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. PRIDE Research Foundation, 5701 Maple Ave. #100, Dallas, TX, 75235, USA

    Meredith M. Hartzell & Randy Neblett

  2. Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75235, USA

    Tom G. Mayer

  3. Department of Psychology, College of Science, The University of Texas at Arlington, 313 Life Science Building, Arlington, TX, 76019, USA

    Robert J. Gatchel

  4. Department of Management, College of Business, The University of Texas at Arlington, 701 S. West Street, Arlington, TX, 76019, USA

    Dennis J. Marquardt

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  1. Meredith M. Hartzell
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  5. Robert J. Gatchel
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Correspondence to Tom G. Mayer.

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Hartzell, M.M., Mayer, T.G., Neblett, R. et al. Does the Economy Affect Functional Restoration Outcomes for Patients with Chronic Disabling Occupational Musculoskeletal Disorders?. J Occup Rehabil 25, 378–386 (2015). https://doi.org/10.1007/s10926-014-9546-1

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