Does medical certification of workers with injuries influence patterns of health service use?

BACKGROUND: Among workers with injuries who seek compensation, a general practitioner (GP) usually plays an important role in a person's return to work (RTW) by advising if the worker is unfit for work (UFW), is able to work on alternate (ALT) duties or is fit for work and also providing referrals to other health service providers. 

OBJECTIVE: To examine patterns of health service utilization (HSU) in workers with injuries by condition and type of certificate issued by GP. 

METHODS: Zero-inflated negative binomial and logistic regressions were conducted for major healthcare services accessed over the 12-month period post-initial medical examination. Services included GP consultations, pharmacy, physiotherapy, occupational rehabilitation and psychology. 

RESULTS: The average number of physiotherapy services was greater in workers with musculoskeletal disorders, back pain and fractures. In contrast, the median number of psychological services was greater in mental health conditions (MHC). Workers with ALT certificates were more likely to use GPs, pharmacy and physiotherapy services. 

CONCLUSION: HSU in the 12 months post-initial medical certification varied substantially according to the worker's condition, certificate type, age, gender and residential location. Understanding these factors can facilitate more appropriate resource allocation; strategic thinking on optimal use of particular health services and enables better targeting of particular provider groups for more education on the health benefits of RTW.