Aggressive early medical management by a specialist in physical medicine and rehabilitation: effect on lost time due to injuries in hospital employees
Article Abstract:
Hospital workers are at particularly high risk for occupational injuries. In an effort to reduce the duration of disability from these injuries, one hospital instituted an early, aggressive medical management program. This study assessed the effectiveness of that program, which was designed to enhance three factors: patient investment in the problem; early assessment of all factors that might delay return to work; and effective communication between employer and physician. The disabled employees were referred to a physiatrist, a specialist in physical functioning and rehabilitation medicine. This physician had primary responsibility for management of the patient's treatment, although he could refer patients to orthopedists or other specialists if appropriate. In terms of employee investment, the employee, after consultation with the physiatrist, was told the nature of his injuries and was asked to develop a plan for return to work. Aggressive medical treatment was applied to all physical problems that would delay return to work. Treatment, rehabilitation, and return to work issues were discussed regularly with the employer. The program shortened the time out from work by 33 percent compared to the previous year before the program was begun. Patients who were managed by the physiatrist averaged 3.9 fewer days out of work. This study demonstrates that referral to a specialist in physical medicine and rehabilitation as early as two days after injury can significantly decrease the duration of the employee's disability. The findings may be particularly important for the treatment of employees with low-back pain. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1990
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Cost per case comparison of back injury claims of chiropractic versus medical management for conditions with identical diagnostic codes
Article Abstract:
There is a need to find methods to control the escalating costs of health care in the United States. This study was undertaken to assess the costs of treating the same type of injury by two provider groups. Back-related injuries, as treated by a medical (MD) or chiropractic (DC) provider, were studied to compare the ''total cost per case'' for the two groups. Data were obtained from the Workers's Compensation Fund of Utah (WCFU). Injuries that occurred in 1986 were extracted in 1988, two years later, to allow for extended loss. A total of 3,062 cases, from 7,551 files that were reviewed, formed the study group. The data were abstracted on the basis of the International Classification of Diseases, 9th Rev. (ICD9) and the Chiropractic Current Procedural Terminology (CCPT) codes. The variables compared between the MD and the DC provider groups were: (1) patient age; (2) number of diagnoses after the primary diagnosis for each patient; (3) number of treatments; (4) number of days of care; (5) number of days worker received compensation payments; (6) cost of compensation; (7) cost for clinical care; (8) total cost of care; and (9) the average cost per office visit. Results of data comparisons indicated that DCs saw patients more frequently, a practice which tended to raise costs. Chiropractic care, however, was ultimately less expensive than medical care, and patients of DCs incurred significantly less compensation costs. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1991
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