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. 1999 Jul;56(7):488–493. doi: 10.1136/oem.56.7.488

Relation between indicators for quality of occupational rehabilitation of employees with low back pain

W E van der Weide, J H Verbeek, F J van Dijk
PMCID: PMC1757763  PMID: 10472321

Abstract

OBJECTIVES: To assess if the implementation of guidelines for occupational rehabilitation of patients with low back pain by means of process variables--a set of objective criteria for technical performance and continuity of care--led to a better outcome in clinical and return to work variables. METHODS: The study group consisted of 59 patients with at least 10 days of sick leave because of low back pain. Univariate analyses as well as multiple logistic regression and Cox's regression analyses were performed to assess the relation between quality of care and outcome. RESULTS: Process indicators for technical competence, continuity of care, and total performance were all significantly related to satisfaction of employees. Continuity of care and total performance were significantly related to working status at 3 months, and time to return to work. None of the process indicators was related to pain or disability after 3 months follow up. Satisfaction was not related to any of the other outcome variables. This indicates that if guidelines for occupational rehabilitation are met, outcome is better. CONCLUSION: Quality of the process of care was related to outcome. Interventions of occupational physicians need improvement in the areas of continuity of care and communication with treating physicians. The effectiveness of an improved intervention should be studied in a subsequent randomised clinical trial.

 

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Selected References

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  1. Basinski A. S. Evaluation of clinical practice guidelines. CMAJ. 1995 Dec 1;153(11):1575–1581. [PMC free article] [PubMed] [Google Scholar]
  2. Beissner K. L., Saunders R. L., McManis B. G. Factors related to successful work hardening outcomes. Phys Ther. 1996 Nov;76(11):1188–1201. doi: 10.1093/ptj/76.11.1188. [DOI] [PubMed] [Google Scholar]
  3. Brook R. H., McGlynn E. A., Cleary P. D. Quality of health care. Part 2: measuring quality of care. N Engl J Med. 1996 Sep 26;335(13):966–970. doi: 10.1056/NEJM199609263351311. [DOI] [PubMed] [Google Scholar]
  4. Cohen G., Forbes J., Garraway M. Can different patient satisfaction survey methods yield consistent results? Comparison of three surveys. BMJ. 1996 Oct 5;313(7061):841–844. doi: 10.1136/bmj.313.7061.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Conbere P. C., McGovern P., Kochevar L., Widtfeldt A. Measuring satisfaction with medical case management. A quality improvement tool. AAOHN J. 1992 Jul;40(7):333–341. [PubMed] [Google Scholar]
  6. Delbanco T. L. Quality of care through the patient's eyes. BMJ. 1996 Oct 5;313(7061):832–833. doi: 10.1136/bmj.313.7061.832. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Deyo R. A. Comparative validity of the sickness impact profile and shorter scales for functional assessment in low-back pain. Spine (Phila Pa 1976) 1986 Nov;11(9):951–954. doi: 10.1097/00007632-198611000-00017. [DOI] [PubMed] [Google Scholar]
  8. Donabedian A. The quality of care. How can it be assessed? JAMA. 1988 Sep 23;260(12):1743–1748. doi: 10.1001/jama.260.12.1743. [DOI] [PubMed] [Google Scholar]
  9. Greenfield S., Cretin S., Worthman L. G., Dorey F. J., Soloman N. E., Goldberg G. A. Comparison of a criteria map to a criteria list in quality-of-care assessment for patients with chest pain: the relation of each to outcome. Med Care. 1981 Mar;19(3):255–272. doi: 10.1097/00005650-198103000-00002. [DOI] [PubMed] [Google Scholar]
  10. Greenfield S., Lewis C. E., Kaplan S. H., Davidson M. B. Peer review by criteria mapping: criteria for diabetes mellitus. The use of decision-making in chart audit. Ann Intern Med. 1975 Dec;83(6):761–770. doi: 10.7326/0003-4819-83-6-761. [DOI] [PubMed] [Google Scholar]
  11. Hazard R. G., Haugh L. D., Green P. A., Jones P. L. Chronic low back pain: The relationship between patient satisfaction and pain, impairment, and disability outcomes. Spine (Phila Pa 1976) 1994 Apr 15;19(8):881–887. [PubMed] [Google Scholar]
  12. Lewis J. R. Patient views on quality care in general practice: literature review. Soc Sci Med. 1994 Sep;39(5):655–670. doi: 10.1016/0277-9536(94)90022-1. [DOI] [PubMed] [Google Scholar]
  13. Linton S. J., Götestam K. G. A clinical comparison of two pain scales: correlation, remembering chronic pain, and a measure of compliance. Pain. 1983 Sep;17(1):57–65. doi: 10.1016/0304-3959(83)90127-6. [DOI] [PubMed] [Google Scholar]
  14. Palmer R. H., Strain R., Maurer J. V., Thompson M. S. A method for evaluating performance of ambulatory pediatric tasks. Pediatrics. 1984 Mar;73(3):269–277. [PubMed] [Google Scholar]
  15. Roland M., Morris R. A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine (Phila Pa 1976) 1983 Mar;8(2):141–144. doi: 10.1097/00007632-198303000-00004. [DOI] [PubMed] [Google Scholar]
  16. Roland M., Morris R. A study of the natural history of low-back pain. Part II: development of guidelines for trials of treatment in primary care. Spine (Phila Pa 1976) 1983 Mar;8(2):145–150. doi: 10.1097/00007632-198303000-00005. [DOI] [PubMed] [Google Scholar]
  17. Stratford P. W., Binkley J., Solomon P., Gill C., Finch E. Assessing change over time in patients with low back pain. Phys Ther. 1994 Jun;74(6):528–533. doi: 10.1093/ptj/74.6.528. [DOI] [PubMed] [Google Scholar]
  18. Vlaeyen J. W., Kole-Snijders A. M., Boeren R. G., van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995 Sep;62(3):363–372. doi: 10.1016/0304-3959(94)00279-N. [DOI] [PubMed] [Google Scholar]
  19. de Bono A. M. Communication between an occupational physician and other medical practitioners--an audit. Occup Med (Lond) 1997 Aug;47(6):349–356. doi: 10.1093/occmed/47.6.349. [DOI] [PubMed] [Google Scholar]
  20. van der Weide W. E., Verbeek J. H., van Dijk F. J., Doef J. An audit of occupational health care for employees with low-back pain. Occup Med (Lond) 1997 Jul;47(5):294–300. doi: 10.1093/occmed/47.5.294. [DOI] [PubMed] [Google Scholar]
  21. van der Weide W. E., Verbeek J. H., van Dijk F. J., Hulshof C. T. Development and evaluation of a quality assessment instrument for occupational physicians. Occup Environ Med. 1998 Jun;55(6):375–382. doi: 10.1136/oem.55.6.375. [DOI] [PMC free article] [PubMed] [Google Scholar]

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