The effect of surgical setting and expedited status on disability duration

In brief

• Some workers’ compensation systems in Canada pay additional surgical fee supplements to expedite care and pay higher fees for surgeries in private clinics, with the goal of reducing surgical wait times and disability time.
• We used claims data and surgery/clinical records from WorkSafeBC to examine the effect of expedited surgical fees and surgical setting (private clinic versus public hospital) on the wait time and return-to-work time following surgery among a sample of workers with work-related knee injuries in BC between 2001 and 2005.
• We found that workers who had expedited surgery in a public hospital had the shortest disability duration from surgical consult to return-to-work.
• The expedited fee reduced the surgical wait-time by about two weeks in both public and private settings, and surgeries performed in public hospitals had a shorter return-to-work time, by about one week.
• An overall difference of approximately three work weeks in disability duration may have meaningful clinical and quality of life implications for injured workers.
• However, minimal differences in expedited surgical wait times by private clinics versus public hospitals, and small differences in return-to-work outcomes favouring the public hospital group, suggest that a future economic evaluation of workers’ compensation policies related to surgical setting is warranted.

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Contact: Mieke Koehoorn