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Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs

Purpose This study investigates the impact of an intensive case management program on sick leave days, permanent work incapacity levels and treatment costs for severe vocational injuries set up by the French National Insurance Fund in five health insurance districts. Methods The method employed reli...

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Autores principales: Leiva, Rolando, Rochaix, Lise, Kiefer, Noémie, Dupont, Jean-Claude K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558282/
https://www.ncbi.nlm.nih.gov/pubmed/33704657
http://dx.doi.org/10.1007/s10926-021-09967-6
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author Leiva, Rolando
Rochaix, Lise
Kiefer, Noémie
Dupont, Jean-Claude K.
author_facet Leiva, Rolando
Rochaix, Lise
Kiefer, Noémie
Dupont, Jean-Claude K.
author_sort Leiva, Rolando
collection PubMed
description Purpose This study investigates the impact of an intensive case management program on sick leave days, permanent work incapacity levels and treatment costs for severe vocational injuries set up by the French National Insurance Fund in five health insurance districts. Methods The method employed relies on a four-step matching procedure combining Coarsened Exact Matching and Propensity Score Matching, based on an original administrative dataset. Average Treatment effects on the Treated were estimated using a parametric model with a large set of covariates. Results After one-year follow-up, workers in the treatment group had higher sickness absence rates, with 22 extra days, and the program led to 2.7 (95% CI 2.3–3.1) times more diagnoses of permanent work incapacity in the treatment group. With an estimated yearly operational cost of 2,722 € per treated worker, the average total extra treatment cost was 4,569 € for treated workers, which corresponds to a cost increase of 29.2% for the insurance fund. Conclusions The higher costs found for the treatment group are mainly due to longer sick leave duration for the moderate severity group, implying higher cash transfers in the form of one-off indemnities. Even though workers in the treated group have more diagnoses of permanent work incapacity, the difference of severity between groups is small. Our results on longer sick leave duration are partly to be explained by interactions between the case managers and the occupational physicians that encouraged patients to stay longer off-work for better recovery, despite the higher costs that this represented for the insurance fund and the well-documented adverse side effects of longer periods off-work. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10926-021-09967-6.
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spelling pubmed-85582822021-11-15 Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs Leiva, Rolando Rochaix, Lise Kiefer, Noémie Dupont, Jean-Claude K. J Occup Rehabil Article Purpose This study investigates the impact of an intensive case management program on sick leave days, permanent work incapacity levels and treatment costs for severe vocational injuries set up by the French National Insurance Fund in five health insurance districts. Methods The method employed relies on a four-step matching procedure combining Coarsened Exact Matching and Propensity Score Matching, based on an original administrative dataset. Average Treatment effects on the Treated were estimated using a parametric model with a large set of covariates. Results After one-year follow-up, workers in the treatment group had higher sickness absence rates, with 22 extra days, and the program led to 2.7 (95% CI 2.3–3.1) times more diagnoses of permanent work incapacity in the treatment group. With an estimated yearly operational cost of 2,722 € per treated worker, the average total extra treatment cost was 4,569 € for treated workers, which corresponds to a cost increase of 29.2% for the insurance fund. Conclusions The higher costs found for the treatment group are mainly due to longer sick leave duration for the moderate severity group, implying higher cash transfers in the form of one-off indemnities. Even though workers in the treated group have more diagnoses of permanent work incapacity, the difference of severity between groups is small. Our results on longer sick leave duration are partly to be explained by interactions between the case managers and the occupational physicians that encouraged patients to stay longer off-work for better recovery, despite the higher costs that this represented for the insurance fund and the well-documented adverse side effects of longer periods off-work. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10926-021-09967-6. Springer US 2021-03-11 2021 /pmc/articles/PMC8558282/ /pubmed/33704657 http://dx.doi.org/10.1007/s10926-021-09967-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Leiva, Rolando
Rochaix, Lise
Kiefer, Noémie
Dupont, Jean-Claude K.
Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs
title Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs
title_full Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs
title_fullStr Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs
title_full_unstemmed Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs
title_short Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs
title_sort evaluating the impact of intensive case management for severe vocational injuries on work incapacity and costs
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558282/
https://www.ncbi.nlm.nih.gov/pubmed/33704657
http://dx.doi.org/10.1007/s10926-021-09967-6
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