0394 Are gender differences in disability duration for work-related musculoskeletal injuries explained by health care utilisation?

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Abstract

Introduction

In British Columbia, Canada, women have longer work disability durations for musculoskeletal injuries than men, even after adjustment for confounders. This study investigated if different types of health care utilisation in the first four weeks of injury explain differences in disability duration.

Methods

Three cohorts were identified from compensation claims for back strain, limb fractures and connective tissue injuries. Claims were restricted to at least four-weeks disability for a standard health care utilisation window. Quantile regression investigated the effect of physician visits (log count), physical therapies and prescriptions (yes/no), on disability days (censored at 365) at the 25th, 50thand 75th percentile by gender.

Results

In multivariable models, physician visits were associated with shorter disability durations for both genders across injury cohorts. For example, for connective tissue injuries, an increase of one physician visit was associated with 44 fewer days [95% CI-64.8,–23.9] for women and 56 fewer days for men [−74.2,–37.5], at the 75th percentile. Opiate prescriptions were associated with longer disability durations for factures only, with 39 more days [95% CI 16.1, 61.3] for women and 46 more days [32.1, 59.3] for men, at the 75th percentile. The effect of physical therapies varied by injury and gender.

Discussion

Physician visits in the first weeks of a compensation claim may be part of return-to-work procedures associated with shorter disability. Opiate prescriptions in the first weeks of a fracture may be a measure of severity associated with longer disability. Health care utilisation did not readily explain longer disability durations for women.

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