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.

Related publications

Urban-rural Differences in the Duration of Injury-related Work Disability in Six Canadian Provinces

Journal article
Macpherson RA, Amick BC, Collie A, Hogg-Johnson S, Koehoorn M, Smith PM, McLeod CB.
Journal of Occupational and Environmental Medicine. 2020 Mar 5. [Epub ahead of print].

Time to return to work following workplace violence among direct healthcare and social workers

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Choi K, Maas ET, Koehoorn M, McLeod CB.
Occupational and Environmental Medicine. 2020 Jan 20. [Epub ahead of print].

Descriptive Epidemiology of Gradual Return to Work for Workers with a Work-acquired Musculoskeletal Disorder in British Columbia, Canada

Journal article
Maas ET, Koehoorn M, McLeod CB.
J Occup Environ Med. 2019 Nov 15. [Epub ahead of print].

Age, sex, and the changing disability burden of compensated work-related musculoskeletal disorders in Canada and Australia

Journal article
Macpherson R, Lane T, Collie A, McLeod C.
BMC Public Health. 2018;18:758.

Do private clinics or expedited fees reduce disability duration for injured workers following knee surgery?

Journal article
Koehoorn, M, McLeod C, Fan J, McGrail K, Barer M, Cote P, Hogg-Johnson S. Healthcare Policy. 2011;7(1):55-70.

Sociodemographic, clinical, and work characteristics associated with return-to-work outcomes following surgery for work-related knee injury

Journal article
Fan JK, McLeod CB, Koehoorn M. Scandinavian Journal of Work, Environment & Health. 2010;36(4):332-338.

Does surgical setting or wait-time incentive improve return to work following knee surgery among injured workers?

Peer-reviewed report to WorkSafeBC
Koehoorn M, McLeod C, Fan J, Barer M, Cote P, Hogg-Johnson S, McGrail K. Vancouver, BC: Centre for Health Services and Policy Research; 2009.

Contact: Mieke Koehoorn

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