Allied health care trajectories for workers’ compensation claims for injuries of the shoulder and low back pain: state sequence analysis

Objectives This study aimed to identify distinct typologies of allied healthcare and their associated factors among workers with accepted workers’ compensation claims for shoulder injuries and low back pain. Methods This retrospective cohort study used data from the Victorian and South Australian workers’ compensation authorities. The cohort included 4317 workers with accepted workers’ compensation claims for shoulder injuries or low back pain from January to December 2022. State sequence analysis identified distinct care typologies based on the type of allied health providers encountered monthly. Results Of the 4317 injured workers included, 34.1% had shoulder injuries and 65.9% had low back pain. Three distinct care typologies emerged: Typology 1 (Sustained Physiotherapy) was the most common (51.8%), characterised by delayed care initiation (median 53 days post-injury). Typology 2 (Early—Short-Term Care) constituted predominantly physiotherapy (39.1%) with early (median, 30 days post-injury) and shorter-term care (median, 9 days). Typology 3 (Diverse Care) represented the smallest typology (9.1%) and was characterised by frequent transitions between care provider type. Compared with the Sustained Physiotherapy typology, younger workers, those with traumatic injuries, workers in South Australia and those who initiated care earlier were more likely to belong to the Early—Short-Term Care typology. Conclusion Allied healthcare trajectories differed significantly over the first year after injury, influenced by worker characteristics, injury type, jurisdiction and the type and timing of initial care provider. Further research is needed to scrutinise implications for work disability and return to work outcomes.