TY  - JOUR
PY  - 2014//
TI  - The association between physical medicine and rehabilitation service utilization and disability duration following work-related fracture
JO  - Work
A1  - Cifuentes, Manuel
A1  - Kurowski, Alicia
A1  - Muhlner, Stasia
A1  - Young, Amanda E.
SP  - 327
EP  - 336
VL  - 51
IS  - 2
N2  - 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>
LA  - en
SN  - 1051-9815
UR  - http://dx.doi.org/10.3233/WOR-141949
ID  - ref1
ER  -