PREVENTION OF WORK-RELATED DISABILITY

Introduction: The cost of work-related injury is large and is rising i n many states. Managed care providers are being asked to assist with s olutions, particularly in the area of facilitating return to work. Kai ser Permanente of the Northwest responded by developing the Kaiser on- the-job program, which includes processes to facilitate the primary, s econdary, and tertiary prevention of work-related disability. Methods: This paper describes the role that managed care can play in the preve ntion of work-related disability through consultation, training, immun ization programs, and targeted screening and case management intervent ions. A quality and case management system is described, which gives p hysicians feedback on modified work and time-off authorization by diag nosis. Results: The results demonstrate statistically significant decr easing physician-authorized average time loss for low back cases from 1991 through 1995 (17.8 disability days per case in 1991 and 15 per ca se in 1995, P = .01). According to Oregon State Accident Insurance Fun d (SAIF Corporation) data, the Kaiser on-the-job average total claims cost was reduced 33% for disabling cases as compared to two other heal th care organizations (P = .002). Conclusions: The methods utilized he re to prevent work-related disability appear effective. They are relev ant to many managed care program models and their efforts to improve w orkplace health and productivity. (C) 1998 American Journal of Prevent ive Medicine.