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Which Characteristics are Associated with the Timing of the First Healthcare Consultation, and Does the Time to Care Influence the Duration of Compensation for Occupational Back Pain?

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Abstract

Purpose To identify the characteristics associated with the timing of the first healthcare consultation and to measure the impact of that timing on the duration of the first episode of compensation for occupational back pain following the injury. Methods We analyzed data from a cohort of workers with compensated back pain in 2005 in Ontario obtained from the Workplace Safety and Insurance Board. Cox multivariable survival models were performed to identify factors associated with the time to care and to measure its association with the length of the first episode of 100 % compensation. Results Among the 5520 claims analyzed, 93.7 % of workers accessed care within the first week (average = 2.1 days; median = 1 day). Time to care was shorter for males, for workers who had received previous compensation and for those with access to an early return to work program. Age, number of employees in the company and personal earnings were positively associated with the time to care. More severe nature of injury, employers doubt about the work-relatedness of the injury and consulting a physiotherapist as the first healthcare provider were also associated with longer time to care. Considering potential confounders, longer time to care was significantly associated with a delay in the end of the first episode of compensation (hazard ratio = 0.98; P < 0.001). Conclusion Temporal access to a source of care is not problematic for the vast majority of Ontarian workers who receive compensation for occupational back pain; however, for the minority of workers who do not rapidly access care, the timing of the first healthcare consultation is a significant predictor of the duration of the first episode of compensation.

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Acknowledgments

The authors thank Ashleigh Burnet and many others from the WSIB for facilitating access to data. M. A. Blanchette is currently supported by a PhD fellowship from the Canadian Institutes for Health Research (CIHR) and previously received PhD grants from both the Quebec Chiropractic Foundation and the CIHR strategic training program in transdisciplinary research on public health intervention (4P). The data extraction was funded through a grant from the WSIB Research Advisory Committee. Dr. Hogg-Johnson reports grants from Workplace Safety & Insurance Board Research Advisory Council, during the conduct of the study; grants from Ontario Ministry of Labour, outside the submitted work.

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Authors and Affiliations

  1. Public Health PhD Program, School of Public Health, University of Montreal, Montreal, QC, Canada

    Marc-André Blanchette

  2. Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada

    Michèle Rivard

  3. Public Health Research Institute, University of Montreal, Montreal, QC, Canada

    Michèle Rivard

  4. Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, QC, Canada

    Clermont E. Dionne

  5. Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec (CHUQ), Québec City, QC, Canada

    Clermont E. Dionne

  6. Institute for Work & Health, Toronto, ON, Canada

    Ivan Steenstra & Sheilah Hogg-Johnson

  7. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Ivan Steenstra & Sheilah Hogg-Johnson

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  1. Marc-André Blanchette
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Correspondence to Marc-André Blanchette.

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Blanchette, MA., Rivard, M., Dionne, C.E. et al. Which Characteristics are Associated with the Timing of the First Healthcare Consultation, and Does the Time to Care Influence the Duration of Compensation for Occupational Back Pain?. J Occup Rehabil 27, 359–368 (2017). https://doi.org/10.1007/s10926-016-9665-y

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