Beyond symptom resolution: insurance case manager’s perspective on predicting recovery after motor vehicle crash

Insurance company case managers can play a critical role in the rehabilitation process of people with musculoskeletal disorders sustained following minor motor vehicle crash injury due to their interaction with multiple stakeholders and their role in approving various services. This study aimed to identify factors that case managers perceive as predictive of recovery in people with musculoskeletal disorders after minor motor vehicle crash injury. To explore the perspectives of cases managers in Australia and the United States, semi-structured interviews explored factors that case managers thought provided an early indication of likely recovery outcomes in people with musculoskeletal disorders after minor motor vehicle crash injury. A framework analysis was applied and factors were displayed within the ICF-framework. Case managers (n = 40) demonstrated a broad, detailed understanding of biopsychosocial and contextual issues influencing recovery. They emphasized the importance of the injured worker’s expressed affect and motivation, style of communication, the role of lawyers, the worker’s family and friends, as well as cultural and geographic influences. The overarching themes perceived as having a major influence on recovery outcomes were general health, pain processing and response, work situation, and compensation entitlement. Case managers’ broad and detailed perceptions about recovery may provide additional, valuable perspectives for professionals involved in the rehabilitation process of people with musculoskeletal disorders after minor motor vehicle crash injury. Further research needs to be conducted to explore the effects of case manager involvement in the process of recovery.Implications for rehabilitationInsurance Case Managers identified multiple factors including affect and motivation, style of communication, the role of lawyers, family and friends, cultural and geographic variation provide opportunities for more effective treatment of people with musculoskeletal disorders related to minor motor vehicle collisions. These managers’ perceptions about recovery may be informative to and provide opportunities for health professionals involved in the rehabilitation of people with musculoskeletal disorders related to minor motor vehicle collisions.While the Insurance Case Managers involved in this research did not use formalized assessment techniques, tools and assessment protocols could be developed jointly between for the needs of Insurance Case Managers and other stakeholders to tackle recovery of people with musculoskeletal disorders related to minor motor vehicle collision. Insurance Case Managers identified multiple factors including affect and motivation, style of communication, the role of lawyers, family and friends, cultural and geographic variation provide opportunities for more effective treatment of people with musculoskeletal disorders related to minor motor vehicle collisions. These managers’ perceptions about recovery may be informative to and provide opportunities for health professionals involved in the rehabilitation of people with musculoskeletal disorders related to minor motor vehicle collisions. While the Insurance Case Managers involved in this research did not use formalized assessment techniques, tools and assessment protocols could be developed jointly between for the needs of Insurance Case Managers and other stakeholders to tackle recovery of people with musculoskeletal disorders related to minor motor vehicle collision.

保险公司案件经理在轻微机动车碰撞事故后患有骨骼肌肉疾病的人的康复过程中扮演着至关重要的角色，这得益于他们与众多利益相关者的互动及其在批准各项服务中的作用。本研究旨在识别案件经理认为预示着轻微机动车碰撞事故后患有骨骼肌肉疾病的人康复因素。为了探究澳大利亚和美国案件经理的视角，半结构化访谈探讨了案件经理认为能为轻微机动车碰撞事故后患有骨骼肌肉疾病的人的康复结果提供早期指示的因素。应用框架分析法，并在国际功能、残疾和健康分类（ICF）框架内展示了这些因素。40名案件经理展现了对于影响康复的生物学、心理学、社会学和环境因素的广泛而深入的认知。他们强调了受伤工人所表达的情感和动机、沟通风格、律师的作用、工人家庭成员和朋友以及文化和地理影响的重要性。被视为对康复结果具有重大影响的总体主题包括一般健康状况、疼痛处理和反应、工作状况以及赔偿权益。案件经理对康复的广泛而详细的认知可能为参与轻微机动车碰撞事故后患有骨骼肌肉疾病的人康复过程的专业人士提供了额外的、有价值的视角。需要进一步的研究来探讨案件经理在康复过程中的作用。对于康复的影响，保险案件经理确定了包括情感和动机、沟通风格、律师的作用、家庭成员和朋友、文化及地理差异在内的多个因素，这为更有效地治疗与轻微机动车碰撞相关的骨骼肌肉疾病患者提供了机会。这些管理者对康复的认知可能对参与与轻微机动车碰撞相关的骨骼肌肉疾病患者康复的健康专业人士具有启发性。尽管参与本研究的研究人员并未采用正式的评估技术、工具和评估协议，但可以考虑由保险案件经理和其他利益相关者共同开发，以满足应对与轻微机动车碰撞相关的骨骼肌肉疾病患者康复的需求。