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The Association between Rural Residence and Return To Work in Workers' Compensation Claimants Open Access


Other title
Injury Claim
Return to Work
Type of item
Degree grantor
University of Alberta
Author or creator
Lavoie, Callum A
Supervisor and department
Gross, Doug (Physical Therapy)
Examining committee member and department
Beach, Jeremy (Medicine)
Voaklander, Don (Public Health)
Gross, Doug (Physical Therapy)
Faculty of Rehabilitation Medicine
Rehabilitation Science
Date accepted
Graduation date
Master of Science
Degree level
ABSTRACT Objectives The objectives of this study were (1) to determine the association between geographic location of residence and recovery from work-related MSK injury in workers’ compensation claimants; and (2) to determine whether the association between geographic location of residence and recovery from work-related MSK injury in workers’ compensation claimants is attenuated or becomes non-significant after controlling for other demographic, occupational, and health risk factors. Methods Secondary analysis of a dataset containing information on 7,843 workers’ compensation claimants from across the province of Alberta who experienced MSK injury was performed. The dataset had information on several variables collected at time of comprehensive clinical/work assessment including location of residence, age, sex, level of education, type of work, injury diagnosis, and health care utilization, among other factors. The dataset also included compensation wage replacement outcomes up to 3 months after the clinical/work assessment. Multivariable risk factor modeling using logistic and cox regression was used to determine the association between rurality and work disability outcomes while controlling for potential confounders. Results Rural claimants were significantly different (p<0.05) from their urban counterparts on several variables. Rural claimants were less likely to be job attached (83.7% vs 85.6%), less likely to require an interpreter during assessment (0.4%vs 4.1%), more likely to not have a high school diploma (15.3% vs 12.8%) or university degree (2.4% vs 6.2%), more likely to work in ‘blue-collar’ jobs (59.4% vs 55.0%), reported lower pain intensity (4.96 vs. 5.14/10), but had more visits to doctors (15.96 vs 13.92) and fewer visits to physiotherapists (18.11 vs 19.47). Univariable modeling found rural residence to be significantly associated with worse outcomes (OR 1.45, 95% Confidence Interval = 1.20-1.75). Multivariable modeling showed that rural residence remained significantly associated with worse outcomes while controlling for potential confounders (adjusted OR 1.57, 95% Confidence Interval = 1.20 – 2.04). Conclusions Rural residence was associated with prolonged work disability, even after controlling for age, job type, education level, health utilization and other potential confounders. Further research is required to explore why injured workers in rural settings experience difficulty with recovery from work-related injury.
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