Time to Service and Its Relationship with Outcomes in Workers with Compensated Musculoskeletal Conditions: A Scoping Review.
Tesfaye Hambisa Mekonnen, Michael Di Donato, Alex Collie and 1 others
PMID 38214782WHAT IT FOUND
Early physical therapy and biopsychosocial care linked to faster return to work.
Early MRI and opioids linked to longer disability and higher costs. Delayed surgery worsened neck outcomes. Timely access matters, but the specific service changes the result.
Key findings
01Early physical therapy and interdisciplinary biopsychosocial interventions were associated with positive outcomes like reduced pain, faster return to work, and lower costs.
02Early use of opioids and MRI was associated with negative outcomes including longer disability duration, increased costs, and poorer health results.
03Factors such as male gender, older age, and higher injury severity were associated with shorter time to service, while employer doubt and physiotherapist-first models were linked to delays.
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
The review did not assess the methodological quality of the included studies. Definitions of 'early' and 'delayed' service varied widely across studies, making direct comparison difficult. Most studies relied on administrative data, which may lack detail on injury severity and clinical context. Findings are limited to workers' compensation populations and may not apply to the general public. The review focused primarily on low back pain, with less evidence for other musculoskeletal conditions.
Declared interests
The study was supported by Monash Graduate Scholarship and Monash International Tuition Scholarship, and Monash University.
The easy way to misread this
Do not assume that 'early' service is always beneficial. Early MRI and opioid administration are associated with worse outcomes, including longer disability and higher costs. The benefit of timeliness applies specifically to evidence-based interventions like physical therapy and biopsychosocial care.