Shoulder surgery in workers compensation patients what the figures say
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Shoulder surgery in workers’ compensation patients What the figures say. John North Michael Francis.

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Shoulder surgery in workers’ compensation patients What the figures say

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Shoulder surgery in workers compensation patients what the figures say

Shoulder surgery in workers’ compensation patientsWhat the figures say

John North

Michael Francis


Shoulder surgery in workers compensation patients what the figures say

On Saturday 11 June 2011, Dr John North, Chairman of the Orthopaedic Assessment Tribunal, delivered a presentation to the Australian Orthopaedic Association Scientific Conference which highlighted some important considerations for insurers and medical practitioners relating to shoulder surgery for workers with a diagnosis of frozen shoulder.

The workers' compensation data set was assessed to evaluate if there were differences in the outcomes for frozen shoulder sufferers for those who had been treated surgically versus conservatively.

A modified version of the presentation is attached.


Shoulder surgery in workers compensation patients what the figures say

Declaration

John North

Chairman, Orthopaedic Assessment Tribunal

Michael Francis

Secretary, Medical Assessment Tribunals (Q-COMP)

Data supplied by Q-COMP


Hypothesis

Hypothesis

Surgery for claimants with a diagnoses of ‘adhesive capsulitis’ (otherwise known as frozen shoulder), generally results in significantly worse outcomes for workers’ compensation patients compared to those who receive non-operative treatment only.


Data assumptions

Data & Assumptions

  • The following data is drawn from a sample of 531 claims

  • The claims are from the Qld workers’ compensation scheme

  • All claims in the sample had a documented diagnosis of ‘adhesive capsulitis’

  • All claims in the sample were finalised between 1 January 2005 & 31 December 2010


Data assumptions1

Data & Assumptions

All claims in the sample were finalised between 1 January 2005 & 31 December 2010

The sample only included claims where there was:

time lost from work; &

medical expenses paid

Surgery for the condition is assumed to have occurred in patients with the diagnosis that have had an overnight stay in hospital for the relevant claim


What the figures say

What the figures say

Surgery is associated with MORE:

Statutory workers comp’ payments

Time off

Allied health costs

P.I. quantum

Common law quantum


Shoulder surgery in workers compensation patients what the figures say

Does this mean that surgery for workers’ compensation patients should never occur?No, but there should be:

Defined indications for surgery

Stringent surgical approval process

Non-operative options fully explored

Informed consent must be comprehensive


Conclusion

Conclusion

Figures are correlational only

but strongly suggest that

surgical intervention

for compensated patients with ‘adhesive capsulitis’

should always be

carefully considered by

surgeons, insurers and patients.


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