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Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers' compensation jurisdictions.

ABSTRACT: Early intervention following occupational injury can improve health outcomes and reduce the duration and cost of workers' compensation claims. Financial early reporting incentives (ERIs) for employers may shorten the time between injury and access to compensation benefits and services. We examined ERI effect on time spent in the claim lodgement process in two Australian states: South Australia (SA), which introduced them in January 2009, and Tasmania (TAS), which introduced them in July 2010.Using administrative records of 1.47 million claims lodged between July 2006 and June 2012, we conducted an interrupted time series study of ERI impact on monthly median days in the claim lodgement process. Time periods included claim reporting, insurer decision, and total time. The 18-month gap in implementation between the states allowed for a multiple baseline design. In SA, we analysed periods within claim reporting: worker and employer reporting times (similar data were not available in TAS). To account for external threats to validity, we examined impact in reference to a comparator of other Australian workers' compensation jurisdictions.Total time in the process did not immediately change, though trend significantly decreased in both jurisdictions (SA: -0.36 days per month, 95% CI -0.63 to -0.09; TAS: 0.35, -0.50 to -0.20). Claim reporting time also decreased in both (SA: -1.6 days, -2.4 to -0.8; TAS: -5.4, -7.4 to -3.3). In TAS, there was a significant increase in insurer decision time (4.6, 3.9 to 5.4) and a similar but non-significant pattern in SA. In SA, worker reporting time significantly decreased (-4.7, -5.8 to -3.5), but employer reporting time did not (-0.3, -0.8 to 0.2).The results suggest that ERIs reduced claim lodgement time and, in the long-term, reduced total time in the claim lodgement process. However, only worker reporting time significantly decreased in SA, indicating that ERIs may not have shortened the process through the intended target of employer reporting time. Lack of similar data in Tasmania limited our ability to determine whether this was a result of ERIs or another component of the legislative changes. Further, increases in insurer decision time highlight possible unintended negative effects.

SUBMITTER: Lane TJ

PROVIDER: S-EPMC5755285 | biostudies-other | 2018 Jan

REPOSITORIES: biostudies-other

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Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers' compensation jurisdictions.

Lane Tyler J TJ Gray Shannon S Hassani-Mahmooei Behrooz B Collie Alex A

BMC public health 20180105 1

<h4>Background</h4>Early intervention following occupational injury can improve health outcomes and reduce the duration and cost of workers' compensation claims. Financial early reporting incentives (ERIs) for employers may shorten the time between injury and access to compensation benefits and services. We examined ERI effect on time spent in the claim lodgement process in two Australian states: South Australia (SA), which introduced them in January 2009, and Tasmania (TAS), which introduced th ...[more]

PMID: 29301515

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Project description:A national tax increase, which became known as the "alcopops tax", was introduced in Australia on the 27th April 2008 on ready-to-drink alcoholic beverages, which are consumed predominantly by young people. The affordability of alcohol has been identified as the strongest environmental driver of alcohol consumption, and alcohol consumption is a well-known risk factor in the spread of sexually transmitted infections via its association with sexual risk-taking. We conducted a study to investigate whether there was any association between the introduction of the tax and changes in national chlamydia rates: (i) notification rates (diagnoses per 100,000 population; primary outcome and standard approach in alcohol taxation studies), and (ii) test positivity rates (diagnoses per 100 tests; secondary outcome) among 15-24 and 25-34-year-olds, using interrupted time series analysis. Gender- and age-specific chlamydia trends among those 35 and older were applied as internal control series and gender- and age-specific consumer price index-adjusted per capita income trends were controlled for as independent variables. We hypothesised that the expected negative association between the tax and chlamydia notification rates might be masked due to increasing chlamydia test counts over the observation period (2000 to 2016). We hypothesised that the association between the tax and chlamydia test positivity rates would occur as an immediate level decrease, as a result of a decrease in alcohol consumption, which, in turn, would lead to a decrease in risky sexual behaviour and, hence, chlamydia transmission. None of the gender and age-specific population-based rates indicated a significant immediate or lagged association with the tax. However, we found an immediate decrease in test positivity rates for 25-34-year-old males (27% reduction-equivalent to 11,891 cases prevented post-tax) that remained detectable up to a lag of six months and a decrease at a lag of six months for 15-24-year-old males (31% reduction-equivalent to 16,615 cases prevented) following the tax. For no other gender or age combination did the change in test positivity rates reach significance. This study adds to the evidence base supporting the use of alcohol taxation to reduce health-related harms experienced by young people and offers a novel method for calculating sexually transmitted infection rates for policy evaluation.

Project description:BackgroundNeuromuscular monitoring should be applied routinely to avoid residual neuromuscular block. However, anaesthetists often refrain from applying it, even when the equipment is available. We aimed to increase neuromuscular monitoring in six Danish anaesthesia departments via e-learning.MethodsInterrupted time series study, with baseline data from a previous study and prospective data collection after implementation of the module, which was available for 2 weeks from 21 November 2016. We included all patients receiving general anaesthesia with muscle relaxants until 30 April 2017. Main outcome was application of acceleromyography, grouped as succinylcholine only and non-depolarising relaxants. Secondary outcomes were last recorded train-of-four ratio (non-depolarising) relaxants and score on a ten-question pre- and post-course multiple-choice test.ResultsThe post-intervention data consisted of 6525 cases (3099 (48%) succinylcholine only, 3426 (52%) non-depolarising relaxants). Analysing all departments, we found a positive pre-intervention trend in application of acceleromyography for both groups, of estimated 7.5% and 4.8% per year, respectively (p < .001). The monitoring rate increased significantly for succinylcholine in two departments post-intervention (p = .045 and .010), and for non-depolarising relaxants in one department (p = .041), but followed by a negative trend of -37.0% per year (p = .041). The rate was already close to 90% at the time of the intervention and the mean last recorded train-of-four ratio was 0.97 (SD 0.21), also without a significant change. The median score on the post-course test increased from 7 (IQR 5-8) to 9 (IQR 8-10) (p < .001, Wilcoxon Signed-Ranks Test).ConclusionWe found no overall effect of the e-learning module on application of neuromuscular monitoring, although the post-course test indicated an effect on anaesthetists' knowledge in this field.Trial registrationTrial registration: Clinicaltrials.gov identifier: NCT02925143. https://clinicaltrials.gov/ct2/show/NCT02925143.

Dataset Information

Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers' compensation jurisdictions.

Publications

Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers' compensation jurisdictions.

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