California: Injured workers satisfied with medical care, study finds

The majority of injured workers in California are pleased with their access to medical care, according to a study by the University of Washington in Seattle. Researchers found that four out of five injured employees reported being satisfied with their care, a level that has remained unchanged since a similar study was conducted in 2006.

Under reforms enacted to the California workers' comp system in 2003, DWC officials are required to contract with an independent firm to perform a study of access to medical treatment for injured workers. Unlike the first report, conducted by the University of California-Los Angeles's Center for Health Policy Research, the 2008 study was designed to provide more detailed information about delays and denials of care, the degree to which barriers interfere with care, and to directly analyze the effect of access barriers on disability. In addition to injured workers, the survey included approximately 800 physicians who provide care to workers' comp patients.

Researchers found that:

Initial care occurred quickly after injury. Nearly 90 percent of respondents obtained initial care within three days of telling their employer about their injury. This was up slightly from 2006.
Majority of workers weren't required to travel far for care. More than 83 percent of injured employees traveled 15 miles or less to their first medical visit.
Most employees said physician provided proper counseling. Researchers said that as many as 89 percent of respondents reported that their doctors provided proper counseling on returning to work safely. In addition, 95 percent of employees were able to visit a physical or occupational therapist upon referral, and 95 percent of those prescribed medication were able to fill their prescriptions.
Physicians' comp patient volume decreased. A little over half (52 percent) of the doctors surveyed indicated their workers' comp patient volume had decreased in the past two years, and one-third (32 percent) reported an intention to decrease volume or quit treating workers' comp patients altogether. The most common reasons cited for planned decreases continued to be paperwork and administrative issues; utilization review issues; restrictiveness of treatment guidelines; and payment, reimbursement, or fee schedule issues.

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"Ways must be found to ease the administrative burden imposed on health care providers that treat injured workers," said Thomas M. Wickizer, affiliate professor at the UW's Department of Health Services and director of the study.

However, not all the findings were positive. Among the nearly 1,000 injured workers surveyed between May and July of 2008, nearly half said they experienced one or more barriers to accessing care. These individuals had longer durations of disability. Workers who encountered access barriers were more likely to be older, have a back or neck injury, have multiple injuries, not speak English well or at all, and have an attorney involved in their case.

"We're pleased to see that injured workers continue to get proper care," said Carrie Nevans, acting administrative director of the California Division of Workers' Compensation. "At the same time, this study does show that when workers have barriers inhibiting access to care they are more likely to be off work longer. While we have a very effective Spanish-language outreach program for injured workers, we're always evaluating how we can do a better job of communicating about services and resources available to help workers navigate what can be a complex system."

Read more at the WorkersComp Forum homepage.

July 12, 2010

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