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Shoulder surgery in workers’ compensation patients What the figures say

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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  1. Shoulder surgery in workers’ compensation patientsWhat the figures say John North Michael Francis

  2. 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.

  3. Declaration John North Chairman, Orthopaedic Assessment Tribunal Michael Francis Secretary, Medical Assessment Tribunals (Q-COMP) Data supplied by Q-COMP

  4. 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.

  5. 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

  6. 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

  7. What the figures say Surgery is associated with MORE: Statutory workers comp’ payments Time off Allied health costs P.I. quantum Common law quantum

  8. 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

  9. 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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