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Impact of a Return-to-Work Program on the Economic Burden of Injury in Malaysia

*Xiaoge Julia Zhang, Johns Hopkins University Bloomberg School of Public Health 
Abdulgafoor M. Bachani, Johns Hopkins University Bloomberg School of Public Health 
Adnan A. Hyder, Johns Hopkins University Bloomberg School of Public Health 

Keywords: Program impact evaluation, Cost of illness, Injury, Return to work

Social security mechanisms are important policy tools for insuring workers and their families against health shocks caused by injury. This study aims to evaluate the impact of a Social Security Return-to-Work program on the economic consequences of injury among individuals and caregivers in Malaysia. We conducted a prospective cohort study---nested within an ongoing study that recruits 1,200 injury patients in two hospitals in Selangor and Kedah, Malaysia-–that consists of one baseline and four follow-up surveys (at 1, 2, 4, 12 months after hospital discharge) to study the participation of subjects in the Return-to-Work program, their injury-related expenses, and support from families and organizations during hospitalization and functional recovery. The outcome measures are cost of injury (direct and indirect) for individuals and caregivers, post-injury employment status, and time to return to work. Propensity score matching methods with mixed-effects models will be used to evaluate the program impact. The study will provide evidence on the long-term economic consequences of injury, with a focus on health systems solutions to address the burden in a developing country.