caa a22 4500 606211292 CHVBK 20210128101037.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10926-014-9539-0 doi (NATIONALLICENCE)springer-10.1007/s10926-014-9539-0 Cost-Effectiveness of Early Versus Delayed Functional Restoration for Chronic Disabling Occupational Musculoskeletal Disorders [Elektronische Daten] [Brian Theodore, Tom Mayer, Robert Gatchel] Purpose Despite extensive evidence for the treatment effectiveness of interdisciplinary functional restoration (FR) for chronic disabling occupational musculoskeletal disorders (CDOMD), there is little documentation on the cost-effectiveness of early rehabilitation using FR. Methods A total of 1,119 CDOMD patients were classified according to duration of disability on FR entry, corresponding to early rehabilitation (ER: 4-8months of disability, N=373), intermediate duration (ID: 9-18months, N=373), and delayed rehabilitation (DR: >18months, N=373). Groups were matched on sex, age, ethnicity, and injured musculoskeletal region. One-year post-rehabilitation outcomes included return-to-work, work retention and healthcare utilization. Economic analyses included a cost-effectiveness analysis of the FR program, and estimation of the total cost-of-illness. Results At 1-year post-rehabilitation, all groups were comparable on return-to-work (overall 88%), work retention (overall 80%), and additional healthcare utilization (overall, 2.2% of patients received re-operations/new surgeries, 2 visits to new healthcare provider). Savings of up to 64% in medical costs, and up to 80% in disability benefits and productivity losses was associated with the ER group. The cost of rehabilitation was also up to 56% lower when administered early. Overall, ER resulted in estimated cost savings of up to 72% (or almost $170,000 per claim). Conclusions Duration of disability does not negatively impact objective work or healthcare utilization outcomes following interdisciplinary FR. However, early rehabilitation is more likely to be a cost-effective solution compared to cases that progress >8months and receiving FR as a treatment of "last resort”. Springer Science+Business Media New York, 2014 Chronic pain nationallicence Disability nationallicence Musculoskeletal disorders nationallicence Functional restoration nationallicence Socioeconomic outcomes nationallicence Cost-effectiveness analysis nationallicence Theodore Brian PRIDE Research Foundation, Dallas, TX, USA aut Mayer Tom Department of Orthopedic Surgery, The University of Texas Southwestern Medical Center at Dallas, 5701 Maple Ave., Suite 100, 75235, Dallas, TX, USA aut Gatchel Robert Department of Psychology, College of Science, The University of Texas at Arlington, Arlington, TX, USA aut Journal of Occupational Rehabilitation Springer US; http://www.springer-ny.com 25/2(2015-06-01), 303-315 1053-0487 25:2<303 2015 25 10926 https://doi.org/10.1007/s10926-014-9539-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10926-014-9539-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Theodore Brian PRIDE Research Foundation, Dallas, TX, USA aut NATIONALLICENCE 700 1- Mayer Tom Department of Orthopedic Surgery, The University of Texas Southwestern Medical Center at Dallas, 5701 Maple Ave., Suite 100, 75235, Dallas, TX, USA aut NATIONALLICENCE 700 1- Gatchel Robert Department of Psychology, College of Science, The University of Texas at Arlington, Arlington, TX, USA aut NATIONALLICENCE 773 0- Journal of Occupational Rehabilitation Springer US; http://www.springer-ny.com 25/2(2015-06-01), 303-315 1053-0487 25:2<303 2015 25 10926