What are the barriers to work participation at 12 and 24 months

following injury?

Results from the New Zealand Prospective Outcomes of Injury

Study

Rebbecca Lilley Injury Prevention Research Unit

19 November 2014

What is known?

Previous studies examining predictors of poor outcomes have focused on: Mainly hospitalised injury Limited range of risk factors

New Zealands context: Accident

Compensation Corporation (ACC)

Research Focus

This study examines combined influences of personal, work, health, lifestyle & injury factors on work absence following injury in the POIS study

Includes psychosocial factors Job strain, job support, job security, job

satisfaction, optimism, self-efficacy, prior depressive episodes

Working Cohort

POIS worker cohort 2626 participants

Injury type: mainly multiple injuries (39%), sprains & strains (26%), fractures (19%)

30% hospital admission

36% work-related

Work participation .

Majority (73%) were working at 3 months Of 720 absent from work at 3 months the

majority (71%) anticipated recovery to usual work

Absent from work long-term: 329 (16%) absent at 12 months 304 (15%) absent at 24 months

WORK STATUS 12 & 24 MONTHS AFTER INJURY

Outcome: Work status 12 & 24 months after injury

Considered working at time of interview regardless of employer or modified/part/full-time status

Outcome of interest: Not working

Pre-injury characteristics Socio-

demographic (10 factors)

Health (6 factors)

Lifestyle (5 factors)

Physical work (5 factors)

Psychosocial (7 factors)

Work organisation

(4 factors)

Injury (6 factors)

Psychosocial factors (pre-injury) Job strain Job support Job security Job satisfaction Self-efficacy Optimism Prior depressive episode

Summary of 12-month results Socio-demographic

(low income, financial insecurity, manual

occupation)

Health (pre-existing condiitions)

Psychosocial (Job satisfaction)

Work organisation (long work hours, parrt-

time work hours temporary & fisxed term employment)

Injury (work-related injury)

Summary of 24-month results Socio-demographic

(low income, financial insecurity, manual

occupation)

Health (pre-existing condiitions)

Psychosocial (Job satisfaction)

Work organisation (number of days

worked, temporary employment)

Injury (work-related injury,

prior injury, injury perceived threat to life)

What factors were not as important?

Age Pre-injury psychosocial factors Pre-injury lifestyle factors

What do we need to do to get injured workers back to work?

Pre-injury socio-demographic, workplace & health factors could be targeted

New findings: Temporary employment Long week work schedules Financial insecurity Work-related injuries

Need for broader intervention focus

Previous POIS analyses 3 month outcomes

Lilley, Davie, Ameratunga, Derrett (2012) Factors predicting work status 3 months after injury. BMJ Open 2: e000400

Comparison of outcomes for workers with Work-related & non-work-related injuries Lilley , Davie, Langley, Ameratunga , Derrett . Do

outcomes differ between work and non-work related injury in a universal injury compensation system? BMC Public Health. 2013; 13:995.

Nested case-control study examining work organisational factors Lilley, Derrett, Davie. Is work organisation

associated with work status 3 months after injury? Work In press 2014.

Return to work and disability trajectories over 12 months following injury Langley, Lilley, Samaranayaka, Derrett . Work

status and disability trajectories over 12 months after injury among workers in New Zealand. NZ Medical Journal, 2014; 127: 53-60.

Acknowledgements Funders: The Health Research Council of New

Zealand (2007-2013) & the Accident Compensation Corporation (2007-2010)

Co-investigators: Gabrielle Davie, Sarah Derrett (Principal

Investigator) https://blogs.otago.ac.nz/ipru/research/pois

What are the barriers to work participation at 12 and 24 months following injury?Results from the New Zealand Prospective Outcomes of Injury StudyWhat is known?Research FocusWorking CohortWork participation .Work status 12 & 24 months after injuryOutcome: Work status 12 & 24 months after injuryPre-injury characteristicsSlide Number 9Summary of 12-month resultsSummary of 24-month resultsWhat factors were not as important?What do we need to do to get injured workers back to work?Previous POIS analysesSlide Number 15Acknowledgements