General Practitioner Service Use Before and After Long-Term Workplace Injury: A Retrospective Cohort Study.

PURPOSE: In Australia, general practitioner (GP) consultations for work-related injuries are funded by workers' compensation and GP care for non-work-related conditions is funded by public health insurance (Medicare Benefits Schedule, MBS). This study aimed to measure changes in the proportion and frequency of GP consultations after a long-term work injury, including both Medicare and workers' compensation funded care, and to assess the proportion of GP services funded by each scheme.

METHOD: This retrospective cohort study linked administrative GP records from MBS and workers' compensation systems in New South Wales, Australia. The study included injured workers with long-duration (2 + years) compensation claims and community comparators. Primary outcome measures included the proportion and frequency of GP services, measured in the year pre-injury, and each of the first two years post-injury. Mixed-effects negative binomial regression was used to compare outcomes between groups during all three study periods.

RESULTS

The cohort included 3170 injured workers and 7636 community controls. The annual median GP services increased from 5 (Interquartile range 2-10) pre-injury to 19 (IQR 12-27) in the first-year post-injury and decreased to 16 (IQR 10-23) in the second year. Compared to the community control cohort, injured workers used 3.6 (95% CI 3.33, 3.81) and 2.7 (95% CI 2.54, 2.91) times more GP services in the first- and second-year post-injury, respectively. This increase in annual median service use was observed among those funded by workers' compensation, while services subsidised by Medicare remained similar across all three study periods.

CONCLUSION

GP service use by injured workers with long-compensation claims increased substantially post-injury and remained high for two years. Workers also continued receiving Medicare-subsidised services at a similar level to pre-injury, presumably for managing non-work-related conditions. An integrated care model may provide holistic support to injured workers needing care for both workplace-injury-related and other conditions.