The self-assessment INTERMED predicts healthcare and social costs of orthopaedic trauma patients with persistent impairments.
Cyrille Burrus, Philippe Vuistiner, Bertrand Léger and 3 others
PMID 32851861WHAT IT FOUND
Each one-point higher self-assessment INTERMED score in 136 orthopaedic trauma patients in rehabilitation was associated with 2% higher healthcare costs, 3% higher lost-wage costs and 4% longer work incapacity.
Key findings
01The analysis included 136 orthopaedic trauma patients in rehabilitation, and higher biopsychosocial complexity was associated with higher healthcare costs, higher social costs and longer fitness-to-work time after adjustment.
02For each one-point higher self-assessment INTERMED score, healthcare costs were expected to increase by 2% and social costs by 3%.
03For each one-point higher self-assessment INTERMED score, work incapacity duration was expected to increase by 4%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 136 of 175 participants were analysed, and 34 were excluded because insurance data were unavailable or they were older than 60 years, so the sample may not represent all orthopaedic trauma patients. The sample was mainly men referred for late rehabilitation after trauma, so the results may not apply to women or to patients assessed soon after injury. Biopsychosocial complexity and employment contract were measured during rehabilitation, not at the time of trauma, so the score may reflect the rehabilitation context or chronicity rather than baseline complexity. The study is observational and adjusted only for measured variables, so it cannot show that a higher INTERMED score causes higher costs or longer fitness-to-work. Patients received a multidisciplinary programme including physiotherapy, occupational therapy, vocational training, social advice and psychological therapy, so the contribution of any single component cannot be separated.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research, authorship or publication.
The easy way to misread this
Do not read the 2%, 3% and 4% per-point increases as proof that the INTERMED score causes higher costs or that screening will improve outcomes. The study was observational, the score was measured during late rehabilitation, and patients received a multidisciplinary programme including physiotherapy, occupational therapy, vocational training, social advice and psychological therapy, so no single component's effect can be separated.