As a relative newcomer to the field of occupational medicine, I’ve become fascinated with the significance of return to work from an illness or injury. When an employee returns to work, especially on a timely basis, most observers would agree that this constitutes a “good outcome.” But that raises a question: what other broadly applicable measures would also constitute a good outcome?
In an era where concern over quality issues in healthcare has never been higher, and attempts to monitor outcomes abound, how, really, are we defining the endpoint of a medical episode and the success of the intervention?
One obvious answer would be discharge from the hospital, but that only signifies recovery from the acute phase of a serious condition. Answers like “When the patient feels better” are subjective and hard to quantify. Often what happens in outpatient or subacute cases is that a string of medical claims is collected and retrospectively analyzed, but that leaves out a vast array of real-life considerations. As “actions speak louder than words”, a patient’s recovery should, intuitively, be pegged to resumption of normal activity.
I have realized that, given the fact that 90% of the people who get sick or injured are working, and that most of them, if properly treated and motivated, resume their productive endeavors when they have recovered, we have, in return to work durations, possibly the single best measure of healthcare outcomes.