Analyzing decline in quality of life by examining employment status changes of occupationally injured workers post medical care

Background: This study aimed to investigate the decline in quality of life (QOL) by examining changes in the employment status of workers who had completed medical treatment after an industrial accident.

Methods: This study utilized the Panel Study of Worker's Compensation Insurance cohort (published in October 2020) containing a sample survey of 3,294 occupationally injured workers who completed medical care in 2017. We divided this population into four groups according to changes in working status. A multivariate logistic regression model was utilized for evaluating QOL decline by adjusting for the basic characteristics and working environment at the time of accident. Subgroup analysis evaluated whether QOL decline differed according to disability grade and industry group.

Results: The QOL decline in the "maintained employment," "employed to unemployed," "remained unemployed," and "unemployed to employed" groups were 15.3%, 28.1%, 20.2%, and 11.9%, respectively. The "maintained employment" group provided a reference. As a result of adjusting for the socioeconomic status and working environment, the odds ratios (ORs) of QOL decline for the "employed to unemployed" group and the "remained unemployed" group were 2.13 (95% confidence interval [CI], 1.51-3.01) and 1.47 (95% CI, 1.13-1.90), respectively. The "unemployed to employed" group had a non-significant OR of 0.76 (95% CI, 0.54-1.07).

Conclusions: This study revealed that continuous unemployment or unstable employment negatively affected industrially injured workers' QOL. Policy researchers and relevant ministries should further develop and improve "return to work" programs that could maintain decent employment avenues within the workers' compensation system.