Age Differences in Work-Disability Duration Across Canada: Examining Variations by Follow-Up Time and Context
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Age Differences in Work‑Disability Duration Across Canada: Examining Variations by Follow‑Up Time and Context Jonathan K. Fan1,2 · Robert A. Macpherson3 · Peter M. Smith1,2,4 · M. Anne Harris1,5 · Monique A. M. Gignac1,2 · Christopher B. McLeod2,3
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose This study aimed to understand age differences in wage-replacement duration by focusing on variations in the relationship across different periods of follow-up time. Methods We used administrative claims data provided by six workers’ compensation systems in Canada. Included were time-loss claims for workers aged 15–80 years with a work-related injury/ illness during the 2011 to 2015 period (N = 751,679 claims). Data were coded for comparability across cohorts. Survival analysis examined age-related differences in the hazard of transitioning off (versus remaining on) disability benefits, allowing for relaxed proportionality constraints on the hazard rates over time. Differences were examined on the absolute (hazard difference) and relative (hazard ratios [HR]) scales. Results Older age groups had a lower likelihood of transitioning off wage-replacement benefits compared to younger age groups in the overall models (e.g., 55–64 vs. 15–24 years: HR 0.62). However, absolute and relative differences in age-specific hazard rates varied as a function of follow-up time. The greatest age-related differences were observed at earlier event times and were attenuated towards a null difference across later followup event times. Conclusions Our study provides new insight into the workplace injury/illness claim and recovery processes and suggests that older age is not always strongly associated with worse disability duration outcomes. The use of data from multiple jurisdictions lends external validity to our findings and demonstrates the utility of using cross-jurisdictional data extracts. Future work should examine the social and contextual determinants that operate during various recovery phases, and how these factors interact with age. Keywords Age · Work injury · Return to work · Workers’ compensation · Survival analysis
Background A large body of research has examined age-related similarities and differences in return to work (RTW) following a workplace injury [1–6]. Although older age has been linked
* Jonathan K. Fan [email protected] 1
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
2
Institute for Work & Health, Toronto, ON, Canada
3
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
4
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
5
School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada
with positive health and well-being outcomes [1], studies find that older age tends to be associated with negative RTW outcomes such as delayed time to RTW, greater duration of sickness absence, and more frequent disability recurrence
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