@article{ref1,
title="The association between physical medicine and rehabilitation service utilization and disability duration following work-related fracture",
journal="Work",
year="2014",
author="Cifuentes, Manuel and Kurowski, Alicia and Muhlner, Stasia and Young, Amanda E.",
volume="51",
number="2",
pages="327-336",
abstract="BACKGROUND: Rural residents with work-related fractures utilize healthcare differently and return to work (RTW) sooner than their similarly-injured urban peers. <br><br>OBJECTIVE: To elucidate the relationship between physical medicine and rehabilitation (PM&R) service usage and work-disability duration following work-related injury. <br><br>DESIGN: Retrospective cohort study, employing a two-phase sequential analysis. The project involved a longitudinal analysis of PM&R utilization and work-disability duration of 2,216 people across the U.S. who fractured a bone, received PM&R services, and had at least seven days off work. In the first phase of the analysis each individual was assigned a PM&R utilization score based on how similar his or her usage was to that typical of rural residents. The second phase tested the relationship between assigned PM&R utilization scores and work-disability duration. <br><br>RESULTS: Differences in urban versus rural PM&R utilization included less total PM&R services and fewer passive services in the first 8 weeks for rural claimants. Among those off work for more than a month, rural residents used more active services just prior to RTW, with a gradual decreasing of services leading up to RTW. Controlling for covariates, aggregate PM&R utilization scores were found to relate to time to first RTW (Hazard Ratio=1.66, p < 0.005).<br><br>CONCLUSIONS: Findings suggest that using services in a way that is more consistent with rural patterns is associated with decreased work-disability durations. Consistent with previous studies, results suggest that passive services, prolonged episodes of care, and failure to focus on transitioning to self-management are related to longer work-disability durations.<p /> <p>Language: en</p>",
language="en",
issn="1051-9815",
doi="10.3233/WOR-141949",
url="http://dx.doi.org/10.3233/WOR-141949"
}