The Impact of Program Participation and Biopsychosocial Factors on Successful Return to Work for Ohio Workers With Nontraumatic Shoulder Injuries

Date of Conferral

11-6-2023

Degree

Ph.D.

School

Public Health

Advisor

Loretta Shields

Abstract

Injured workers (IWs) with nontraumatic shoulder injuries (NTSIs) have a high potential for delayed return to work (RTW) and long-term disability; however, there is limited research on the factors that influence RTW. The purpose of this study was to assess (a) the relationship between chosen RTW path and successful RTW (SRTW) for IWs with NTSIs and (b) the impact of examined biopsychosocial (BPS) factors on this relationship. BPS theory underpinned this deductive study. A retrospective cohort of NTSI claims (N = 5,237) from the Ohio Bureau of Workers’ Compensation was examined. Analysis of variance and Kaplan-Meier survival analyses indicated that time to SRTW differed among the RTW paths (F4,3950 = 437.79, p < .001), with vocational rehabilitation (VR) having the longest median time (1,023 days) and transitional work (TW) the shortest (108 days), followed by modified work (MW; 121 days). The Cox proportional hazards regression model indicated that compared to VR, cases utilizing MW were 3.53 times more likely to successfully RTW (HR = 3.53, p < .001). Those utilizing TW and two or more programs were, respectively, 4.02 times (HR = 4.02, p < .001) and 1.50 times (HR = 1.50, p < .001) more likely to successfully RTW. The BPS factors of gender, marital status, rural status, and average weekly wage had a positive impact, reducing time to SRTW, whereas age, diabetes status, and employer group increased time to SRTW. These findings could inform the development of workers’ compensation agency claim management practices to reduce costs and quality of life impacts for IWs and their families, and reduce the societal burden of long-term disability.

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