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Integrating health-related quality of life with sickness leave days for return-to-work assessment in traumatic limb injuries

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Abstract

Purpose

A novel indicator called health-adjusted leave days (HALDs) is proposed. It integrates the opposite level of health-related quality of life (HRQoL) with the sick leave days (LDs) before return-to-work (RTW) to better measure the impact of injuries on occupational health.

Methods

A total of 1,167 limb injuries were consecutively recruited in a teaching hospital from January to December 2009. The number of LDs was calculated between the date of injury and the first episode of RTW. Each subject was repeatedly assessed with EuroQol instrument (EQ-5D) before RTW. The HRQoL index is defined as 1 minus the EQ-5D utility and re-scaled to 0–1 range to reflect the impact of injuries. The expected HALD of each group is calculated by integrating the product of the proportion of non-RTW function and the mean HRQoL index function over the days followed up to 2 years for the group. We compared the expected HALDs between subgroups according to various demographic characteristics and consequences of injury.

Results

Older and female workers tended to have longer LDs than men and younger workers, with an increase in percentage change of 16.0 or 139.5 %, respectively. After adjusting for HRQoL index, the percentages for HALDs were changed to 28.7 or 186.6 %, respectively. The percentages for the less-educated workers and blue collar workers were 185.7 and 155.8 %. The expected HALDs showed statistical significant differences in all subgroup analyses.

Conclusion

We believed that the proposed HALD could better measure the impact of injuries and is potentially useful for the clinical decision and industrial policy-making with respect to the assessment of the importance of limb injury due to a worker’s sick leaves.

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Abbreviations

HALDs:

Health-adjusted leave days

HRQoL:

Health-related quality of life

LDs:

Leave days

RTW:

Return-to-work

QOL:

Quality of life

LOS:

Length of hospital stay

EQ-5D:

EuroQol instrument

References

  1. Ezzati, M., Lopez, A. D., Rodgers, A., Vander Hoorn, S., & Murray, C. J. (2002). Selected major risk factors and global and regional burden of disease. Lancet, 360(9343), 1347–1360.

    Article  PubMed  Google Scholar 

  2. Ebel, B. E., Mack, C., Diehr, P., & Rivara, F. P. (2004). Lost working days, productivity, and restraint use among occupants of motor vehicles that crashed in the United States. Injury Prevention, 10(5), 314–319.

    Article  PubMed  CAS  Google Scholar 

  3. Liu, Y. H., Lin, M. R., & Wang, J. D. (1995). Cost and determinants of morbidity from work related disabling injuries in Taiwan. Occupational and Environmental Medicine, 52(2), 138–142.

    Article  PubMed  CAS  Google Scholar 

  4. Pransky, G. S., Benjamin, K. L., Savageau, J. A., Currivan, D., & Fletcher, K. (2005). Outcomes in work-related injuries: A comparison of older and younger workers. American Journal of Industrial Medicine, 47(2), 104–112.

    Article  PubMed  Google Scholar 

  5. Lin, S. H., Lee, H. Y., Chang, Y. Y., Jang, Y., & Wang, J. D. (2011). Estimation of life expectancies and loss-of-life expectancies for workers with permanent occupational disabilities of the extremities—a 21-year follow-up study. Scandinavian Journal of Work, Environment & Health, 38(1), 70–77.

    Article  Google Scholar 

  6. Segui-Gomez, M., & MacKenzie, E. J. (2003). Measuring the public health impact of injuries. Epidemiologic Reviews, 25, 3–19.

    Article  PubMed  Google Scholar 

  7. Polinder, S., van Beeck, E. F., Essink-Bot, M. L., Toet, H., Looman, C. W., Mulder, S., et al. (2007). Functional outcome at 2.5, 5, 9, and 24 months after injury in the Netherlands. The Journal of Trauma, 62(1), 133–141.

    Article  PubMed  Google Scholar 

  8. MacKenzie, E. J., Shapiro, S., Smith, R. T., Siegel, J. H., Moody, M., & Pitt, A. (1987). Factors influencing return to work following hospitalization for traumatic injury. American Journal of Public Health, 77(3), 329–334.

    Article  PubMed  CAS  Google Scholar 

  9. Soberg, H. L., Roise, O., Bautz-Holter, E., & Finset, A. (2011). Returning to work after severe multiple injuries: Multidimensional functioning and the trajectory from injury to work at 5 years. The Journal of Trauma, 71(2), 425–434.

    Article  PubMed  Google Scholar 

  10. Soberg, H. L., Finset, A., Bautz-Holter, E., Sandvik, L., & Roise, O. (2007). Return to work after severe multiple injuries: A multidimensional approach on status 1 and 2 years postinjury. The Journal of Trauma, 62(2), 471–481.

    Article  PubMed  Google Scholar 

  11. MacKenzie, E. J., Morris, J. A., Jr, Jurkovich, G. J., Yasui, Y., Cushing, B. M., Burgess, A. R., et al. (1998). Return to work following injury: The role of economic, social, and job-related factors. American Journal of Public Health, 88(11), 1630–1637.

    Article  PubMed  CAS  Google Scholar 

  12. Hou, W. H., Tsauo, J. Y., Lin, C. H., Liang, H. W., & Du, C. L. (2008). Worker’s compensation and return-to-work following orthopaedic injury to extremities. Journal of Rehabilitation Medicine, 40(6), 440–445.

    Article  PubMed  Google Scholar 

  13. MacKenzie, E. J., Bosse, M. J., Kellam, J. F., Pollak, A. N., Webb, L. X., Swiontkowski, M. F., et al. (2006). Early predictors of long-term work disability after major limb trauma. The Journal of Trauma, 61(3), 688–694.

    Article  PubMed  Google Scholar 

  14. Garratt, A., Schmidt, L., Mackintosh, A., & Fitzpatrick, R. (2002). Quality of life measurement: Bibliographic study of patient assessed health outcome measures. British Medical Journal, 324(7351), 1417.

    Article  PubMed  Google Scholar 

  15. Chuang, H. Y., Chao, K. Y., & Wang, J. D. (2005). Estimation of burden of lead for offspring of female lead workers: A quality-adjusted life year (QALY) assessment. Journal of Toxicology and Environmental Health, Part A, 68(17–18), 1485–1496.

    Article  CAS  Google Scholar 

  16. Lee, H. Y., Hwang, J. S., Jeng, J. S., & Wang, J. D. (2010). Quality-adjusted life expectancy (QALE) and loss of QALE for patients with ischemic stroke and intracerebral hemorrhage: A 13-year follow-up. Stroke, 41(4), 739–744.

    Article  PubMed  Google Scholar 

  17. Hsu, C., Wang, J. D., Hwang, J. S., Tien, H. F., Chang, S. M., Cheng, A. L., et al. (2003). Survival-weighted health profile for long-term survivors of acute myelogenous leukemia. Quality of Life Research, 12(5), 503–517.

    Article  PubMed  Google Scholar 

  18. Lee, H. Y., Chen, Y. H., Chiu, W. T., Hwang, J. S., & Wang, J. D. (2010). Quality-adjusted life-years and helmet use among motorcyclists sustaining head injuries. American Journal of Epidemiology, 100(1), 165–170.

    Google Scholar 

  19. Hou, W. H., Sheu, C. F., Liang, H. W., Hsieh, C. L., Lee, Y., Chuang, H. Y., et al. (2012). Trajectories and predictors of return to work after traumatic limb injury—a 2-year follow-up study. Scandinavian Journal of Work, Environment & Health, 38(5), 456–466.

    Article  Google Scholar 

  20. Hou, W. H., Liang, H. W., Sheu, C. F., Hsieh, C. L., & Chuang, H. Y. (2012). Return to work and quality-of-life in workers with traumatic limb injuries: A 2-year repeated measurements study. Archives of physical and Medical Rehabilitation. doi:10.1016/j.jacr.2012.08.005.

  21. Chang, T. J., Tarn, Y. H., Hsieh, C. L., Liou, W. S., Shaw, J. W., & Chiou, X. G. (2007). Taiwanese version of the EQ-5D: Validation in a representative sample of the Taiwanese population. Journal of the Formosan Medical Association, 106(12), 1023–1031.

    Article  PubMed  Google Scholar 

  22. The EuroQol Group. (1990). EuroQol–a new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199–208.

    Article  Google Scholar 

  23. Burstrom, K., Johannesson, M., & Diderichsen, F. (2001). Swedish population health-related quality of life results using the EQ-5D. Quality of Life Research, 10(7), 621–635.

    Article  PubMed  CAS  Google Scholar 

  24. Johnson, J. A., Luo, N., Shaw, J. W., Kind, P., & Coons, S. J. (2005). Valuations of EQ-5D health states: Are the United States and United Kingdom different? Medical Care, 43(3), 221–228.

    Article  PubMed  Google Scholar 

  25. Dolan, P. (1997). Modeling valuations for EuroQol health states. Medical Care, 35(11), 1095–1108.

    Article  PubMed  CAS  Google Scholar 

  26. Derrett, S., Black, J., & Herbison, G. P. (2009). Outcome after injury-a systematic literature search of studies using the EQ-5D. The Journal of Trauma, 67(4), 883–890.

    Article  PubMed  Google Scholar 

  27. Hwang, J. S., & Wang, J. D. (2004). Integrating health profile with survival for quality of life assessment. Quality of Life Research, 13(1), 1–10 (discussion 11–14).

    Google Scholar 

  28. Hwang, J. S., & Wang, J. D. (1999). Monte Carlo estimation of extrapolation of quality-adjusted survival for follow-up studies. Statistics in Medicine, 18(13), 1627–1640.

    Article  PubMed  CAS  Google Scholar 

  29. Lin, S. H., Lee, H. Y., Chang, Y. Y., Jang, Y., & Wang, J. D. (2012). Estimation of life expectancies and loss-of-life expectancies for workers with permanent occupational disabilities of the extremities–a 21-year follow-up study. Scandinavian Journal of Work, Environment & Health, 38(1), 70–77.

    Article  Google Scholar 

  30. Rosser, R. M., & Watts, V. C. (1972). The measurement of hospital output. International Journal of Epidemiology, 1(4), 361–368.

    Article  PubMed  CAS  Google Scholar 

  31. Lopez, A. D., & Mathers, C. D. (2006). Measuring the global burden of disease and epidemiological transitions: 2002–2030. Annals of Tropical Medicine and Parasitology, 100(5–6), 481–499.

    Article  PubMed  CAS  Google Scholar 

  32. Chu, P. C., Wang, J. D., Hwang, J. S., & Chang, Y. Y. (2008). Estimation of life expectancy and the expected years of life lost in patients with major cancers: Extrapolation of survival curves under high-censored rates. Value in Health, 11(7), 1102–1109.

    Article  PubMed  Google Scholar 

  33. Ho, J. J., Hwang, J. S., & Wang, J. D. (2006). Life-expectancy estimations and the determinants of survival after 15 years of follow-up for 81 249 workers with permanent occupational disabilities. Scandinavian Journal of Work, Environment & Health, 32(2), 91–98.

    Article  Google Scholar 

  34. Ho, J. J., Hwang, J. S., & Wang, J. D. (2006). Estimation of reduced life expectancy from serious occupational injuries in Taiwan. Accident Analysis and Prevention, 38(5), 961–968.

    Article  PubMed  Google Scholar 

  35. Lin, S. H., Lee, H. Y., Chang, Y. Y., Jang, Y., Chen, P. C., & Wang, J. D. (2010). Increased mortality risk for workers with a compensated, permanent occupational disability of the upper or lower extremities: A 21-year follow-up study. American Journal of Epidemiology, 171(8), 917–923.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank Chen-Long Wu for expert opinion, Tsuey-Hwa Hu for statistical assist, and Pei-Shan Li for document collection. This study was supported by research grants from the National Science Council (NSC 99-2314-B-650-001-MY2 and NSC 101-2314-B-038-055-) and the E-Da Hospital (EDAHP-99001 and EDAHP-101002).

Author information

Authors and Affiliations

  1. Department of Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan

    Wen-Hsuan Hou

  2. School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan

    Wen-Hsuan Hou

  3. Department of Physical Medicine and Rehabilitation, E-Da Hospital, Kaohsiung, Taiwan

    Wen-Hsuan Hou

  4. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Huey-Wen Liang

  5. School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Ching-Lin Hsieh

  6. Institute of Education, College of Social Science, National Cheng Kung University, Tainan, Taiwan

    Ching-Fan Sheu

  7. Institute of Statistical Science, Academia Sinica, Taipei, Taiwan

    Jing-Shiang Hwang

  8. Department of Public Health, College of Health Sciences, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan

    Hung-Yi Chuang

  9. Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, 100, Tz-You 1st Road, Kaohsiung, 80708, Taiwan

    Hung-Yi Chuang

Authors
  1. Wen-Hsuan Hou
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  2. Huey-Wen Liang
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Corresponding author

Correspondence to Hung-Yi Chuang.

Additional information

Jing-Shiang Hwang and Hung-Yi Chuang contributed equally to this work.

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Hou, WH., Liang, HW., Hsieh, CL. et al. Integrating health-related quality of life with sickness leave days for return-to-work assessment in traumatic limb injuries. Qual Life Res 22, 2307–2314 (2013). https://doi.org/10.1007/s11136-013-0364-2

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