Insurance Work and Health Group, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia.
Centre of Research Excellence in Recovery Following Road Traffic Injuries, Herston, Australia.
J Occup Rehabil. 2018 Dec;28(4):740-748. doi: 10.1007/s10926-018-9761-2.
Purpose To determine the incidence of employed people who try and fail to return-to-work (RTW) following a transport crash. To identify predictors of RTW failure.
A historical cohort study was conducted in the state of Victoria, Australia. People insured through the state-based compulsory third party transport accident compensation scheme were included. Inclusion criteria included date of crash between 2003 and 2012 (inclusive), age 15-70 years at the time of crash, sustained a non-catastrophic injury and received at least 1 day of income replacement. A matrix was created from an administrative payments dataset that mapped their RTW pattern for each day up to 3 years' post-crash. A gap of 7 days of no payment followed by resumption of a payment was considered a RTW failure and was flagged. These event flags were then entered into a regression analysis to determine the odds of having a failed RTW attempt.
17% of individuals had a RTW fail, with males having 20% lower odds of experiencing RTW failure. Those who were younger, had minor injuries (sprains, strains, contusions, abrasions, non-limb fractures), or were from more advantaged socio-economic group, were less likely to experience a RTW failure. Most likely to experience a RTW failure were individuals with whiplash, dislocations or particularly those admitted to hospital.
Understanding the causes and predictors of failed RTW can help insurers, employers and health systems identify at-risk individuals. This can enable earlier and more targeted support and more effective employment outcomes.
目的 确定在交通碰撞后试图重返工作岗位（RTW）但失败的就业人员的发生率。确定 RTW 失败的预测因素。
在澳大利亚维多利亚州进行了一项历史队列研究。纳入通过州强制第三方交通事故赔偿计划投保的人。纳入标准包括 2003 年至 2012 年（含）期间发生的碰撞日期、碰撞时年龄在 15-70 岁之间、非灾难性损伤和至少获得 1 天的收入替代。从管理支付数据集创建了一个矩阵，该矩阵为每个 RTW 模式映射了他们在碰撞后 3 年的每一天。如果连续 7 天没有支付工资，然后恢复支付，则被认为是 RTW 失败，并标记。然后将这些事件标志输入回归分析，以确定 RTW 尝试失败的可能性。
17%的人 RTW 失败，男性经历 RTW 失败的可能性低 20%。那些年龄较小、受伤较轻（扭伤、拉伤、挫伤、擦伤、非肢体骨折）或来自社会经济地位较高群体的人，不太可能经历 RTW 失败。最有可能经历 RTW 失败的是患有挥鞭伤、脱位或特别住院的人。
了解 RTW 失败的原因和预测因素可以帮助保险公司、雇主和卫生系统识别高风险个体。这可以实现更早和更有针对性的支持，并实现更有效的就业结果。
