A review of health-related work outcome measures and their uses, and recommended measures

Despite the growing recognition that work can contribute to the development of musculoskeletal disorders,(1,8) there are almost no data on whether and how physicians investigate the contribution of work to patients' health st atus or the influence of health status on work performance. This is particu larly true of primary care, where much of the medical care for patients wit h work-related low back pain is provided.(51) As more patients with musculo skeletal injuries show up in primary care settings, it will become importan t to document health-related work outcomes and incorporate into practice ou tcome tools that enable the physician to obtain a quick and accurate accoun ting of needed information about patients' work. Health-related work outcomes relate to a person's labor market status: Is a person working or not working? How well is he or she working? Did the pers on return to a job of pay and skill comparable to the preinjury job? Outcom es can incorporate time: How long has a person been out of work? How many h ours, days, or weeks has a person been reported absent? Is the person worki ng full- or part-time? How many hours does the person perform at full effec tiveness? Finally, health-related work outcomes can capture the interplay b etween a person's health status and work role performance: How difficult is it for a person with a given health status to perform work activities? Typ ically, health-related work outcomes have not specifically referred to unpa id work activities, such as volunteer work or household labor. The authors support the importance of capturing both paid and unpaid work outcomes, but in this article, paid work is the focus. Multiple publications in the literature contribute conceptually and methodo logically to the health-related work outcomes field. These range from indus trial psychology and labor economics to health services research, epidemiol ogy, and pharmacoeconomics. In this paper, a window into health-related wor k outcomes research is created by considering the reasons for measuring the se outcomes and briefly reviewing and illustrating several classes of measu res. The advantages and limitations of each measure will be discussed, as t he authors draw examples from own work. Although prior work has focused on upper extremity musculoskeletal disorders, the general principles for using health-related work outcomes are similar for researchers studying back inj uries and disorders. In addition, a new work-related health outcome tool fo r measuring successful return to work (RTW) is discussed to illustrate a ne w class of measures, Hereafter, health-related work outcomes as are referre d to as work outcomes.