Working Paper #203: Health-care utilization for work-related soft-tissue injuries: Understanding the role of providers

Work-related soft-tissue injuries are the single largest cause of lost-time injuries in Canada, accounting for more than half of all compensated claims in Ontario. The effectiveness of different clinical interventions to help workers recover remains uncertain.

While other research has examined the relationship between health-care utilization and provider type, few researchers have studied whether the potential selection of health-care provider is related to injury severity.

This paper reports that in this study, researchers collected data from about 1,300 Ontario adults who had filed a work-related claim for a soft-tissue injury. The workers, who were still off work at time of interview, had seen a health-care provider within a month of their injuries. Information on health-care services was provided by administrative records from two reimbursement agencies: the Ontario Workplace Safety & Insurance Board and the Ontario Health Insurance Plan.

The paper reports that some health-care providers deliver more intensive (and more costly) care than others. Those who were mainly cared for by doctors were seen less frequently and at lower cost to the system than those treated by other providers. These utilization patterns of differences did not appear related to the type or severity of the soft-tissue injury and the presence of any co-existing illnesses or conditions.

This paper provides evidence that some health-care providers offer more intensive–and expensive–care for work-related soft-tissue injuries than others and that this finding cannot be explained by the selection of patients with more severe injuries. These findings support the efforts of workers’ compensation and health insurance plan administrators in establishing evidence-based standards for the provision of health-care services to patients with soft-tissue injuries.