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  • Study: Functional Restoration Initiated Early Results in Big Savings

    When it comes to interdisciplinary functional restoration (FR) for chronic disabling occupational musculoskeletal disorders (CDOMDs), the earlier the better, according to a new study, which found that FR programs initiated within the first 8 months after the disabling event can lead to health care and economic cost savings of up to 72%, or about $170,000 per claim.

    The study, e-published ahead of print September 7 in the Journal of Occupational Rehabilitation (abstract only available for free), examined financial and socioeconomic outcomes from 1,119 participants with CDOMDs who received FR at different points from the onset of CDOMD—1 group 4-8 months afterwards, a second group 9-18 months afterwards, and a third group receiving FR after 18 months. The groups were matched for demographics and injured musculoskeletal regions.

    Researchers looked at outcomes 1 year after rehabilitation and found that in terms of return-to-work rates, work retention percentages, and additional health care utilization, all 3 groups were similar, with overall rates of 88% for return to work, 80% for work retention, and small rates of additional health care utilization.

    However, big differences were uncovered when the authors looked at overall medical costs and disability benefits/productivity losses, with the early-intervention group demonstrating savings of 64% and 80%, respectively, over the intermediate and late-FR groups. Additionally, researchers estimated that the actual cost of rehabilitation was up to 56% less when FR was initiated early on.

    "Early rehabilitation is more likely to be a cost-effective solution compared to cases that progress [for 8 months or more] and receive FR as a treatment of 'last resort,'" authors write.

    In addition to cost-savings, authors write that early FR "may potentially prevent or mitigate the development of complex psychosocial barriers to treatment, including depression, narcotic dependence, and complex sequelae of comorbid psychopathology."

    While authors acknowledge several limitations to their study—for instance, the study did not include the costs of prescription medications used during the postrehabilitation period—they write that the findings "are consistent with the general principle … that one of the 'first principles to avoid delayed recovery' is critical in enhancing cost-effectiveness of care for acute and chronic musculoskeletal disorders."

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    Comments

    • Early intervention

      Posted by Tim on 9/27/2014 7:30 AM

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