926 Politics in occupational health: example of an evidence-based driven proposal for improving upper-extremity musculoskeletal disorder compensation in france

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IntroductionIn a context of heterogeneous practices, the French government set up a committee and this committe have mandated a technical working group for improving compensation for upper-extremity musculoskeletal disorders.MethodsAfter a state of the art based on international recommendations and French data to take into account the particular nature of compensation in France, a technical working group followed a Delphi-like process for suggesting a method of evaluation. A different group evaluated the work at the end with a validation process.ResultA systematic review has been performed, supplemented with opinions of International experts solicited individually. Analyses of available data were carried out on actual compensation and on a French cohort, as well as an inventory of the various French compensation methods. From this state of the art, the technical working group proposed a first version which was discussed in a workshop, allowing after two rounds a draft that a majority agreed upon (>70% of total agreement). An independent group read and evaluated the work, with over 90% total agreement, and allowed minor comments before the final report.DiscussionIn one year, this project allowed the development of an evidence-based approach aimed at improving compensation for upper-extremity musculoskeletal disorders. An appropriation phase is necessary involving by end-users (i.e. insurance practitioners, with development of practical tools, clinical vignettes), and an economical evaluation.

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