Gray Shannon E, Lane Tyler J, Sheehan Luke, Collie Alex
Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, Australia.
Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, Australia.
Health Policy. 2019 Oct;123(10):982-991. doi: 10.1016/j.healthpol.2019.06.010. Epub 2019 Jul 6.
Delays in workers' compensation claim processing (CP) times have been associated with reduced recovery and delayed return-to-work. This study aimed to (1) determine the injury, worker, and workplace factors associated with CP delays and (2) investigate whether CP delays are associated with longer disability duration after adjusting for these factors. Retrospective cohort analysis of Australian workers' compensation claims was conducted from 1st July 2009 to 30th June 2016 for objective (1) and to 30th June 2014 for objective (2). CP times were derived by calculating differences in days between: injury and lodgement dates (lodgement); lodgement and decision dates (decision) and; injury and decision dates (total). All CP times were shorter for younger workers and those with fractures or traumatic injury, and longer for those with neurological or mental health conditions, and other diseases. Claims from self-insured employers had shorter decision times. With increasing lodgement, decision and total time there was significantly higher hazard of longer disability duration. Findings suggest the need for more efficient claims management to ensure fewer barriers to claim lodgement or approval. This in turn should reduce disability duration and ensure improved return-to-work outcomes.
工伤赔偿申请处理(CP)时间的延迟与康复进程减缓及复工延迟相关。本研究旨在:(1)确定与CP延迟相关的损伤、工人及工作场所因素;(2)在对这些因素进行调整后,调查CP延迟是否与更长的残疾持续时间相关。对2009年7月1日至2016年6月30日期间澳大利亚工伤赔偿申请进行回顾性队列分析以实现目标(1),对至2014年6月30日期间的申请进行分析以实现目标(2)。CP时间通过计算以下日期之间的天数差异得出:损伤日期与提交日期(提交);提交日期与决定日期(决定);以及损伤日期与决定日期(总计)。所有CP时间对于年轻工人以及患有骨折或创伤性损伤的工人来说较短,而对于患有神经或精神健康疾病以及其他疾病的工人来说较长。来自自保雇主的申请的决定时间较短。随着提交、决定和总时间的增加,残疾持续时间延长的风险显著更高。研究结果表明需要更高效的索赔管理,以确保索赔提交或批准的障碍更少。这反过来应减少残疾持续时间,并确保改善复工结果。