Changes in publicly insured general practitioner consultations before and after workplace injury: interrupted time series by consultation duration and care plans in Australia

BACKGROUND: General practitioners (GPs) are central to the treatment and management of injured workers. Australian workers' compensation funds GP consultations for work-related injuries. Almost all other GP consultations are subsidised by public healthcare insurance (Medicare Benefit Scheme). This study aimed to examine changes in publicly-insured GP consultations before and after injury for injured workers with long-duration claims, focusing on consultation duration types and GP-provided mental health and chronic diseases management plans. METHODS: This retrospective cohort study using interrupted time series analysis included 3,755 injured workers and 10,113 community individuals with injury/index date between 2006 and 2016. We compared monthly changes in rates (per 1000 workers) of six GP consultation types for 12-month before and 24-months after injury. Acute and long-term changes were examined both overall (combining all consultation types) and separately by consultation type. Consultation types include four duration-based levels: A (0-6 min), B (6-20 min), C (20-40 min), and D (40-60 min), and two types describing mental health and chronic disease management plans. RESULTS: After injury, injured workers received an additional 1,600 Medicare-subsidised GP consultations per 1,000 workers per year compared to the community group. Post-injury, the largest increase in monthly consultation rates was observed for Level D consultations (IRR: 2.37, 95% CI: 1.35, 4.20), while the smallest increment was observed for Level B consultations (IRR: 1.45, 95% CI: 1.32, 1.59). Monthly GP mental health care and chronic disease development plan rates increased by 84% (IRR: 1.84, 95% CI: 1.17, 2.93) and 20% (IRR: 1.20, 95% CI: 0.78, 1.86) post injury, respectively; however, the monthly rates of these consultations were small (maximum 25/1000 workers) Following these initial increases immediately post-injury, monthly consultation rates decreased by 3% to 9% and by 24-months post-injury had returned to levels observed in the comparison group. CONCLUSION: All six types of publicly insured GP consultations increased temporarily in the initial months following injury, regardless of worker's compensation status. These consultations remained elevated above pre-injury levels for over 12 months, likely reflecting delayed claim acceptance or increased care needs. These findings highlight the need of a comprehensive, whole-person approach to recovery that addresses both immediate and broader healthcare needs.