2016-04-01 12:00 - Messages

Relationship Between Opioid Prescribing Patterns and Claim Duration and Cost

Objective: The aim of this study was to assess the relationship between timing and duration of opioid prescriptions, disability duration, and claims costs for work-related injuries.
Method: A retrospective cohort study using lost time compensation claimant data to examine the relationship between opioid prescription patterns and claim duration and cost. Logistic regression adjusted for sex, marital status, initial reserve, attorney involvement, and spinal surgeries.
Results: Odds ratios for claim cost at least $100,000 and duration at least 3 years were not statistically different between groups prescribed opioids less than 30 days and those not prescribed opioids. Claims with short-acting opioids continued after 180 days; the odds ratios for claim cost at least $100,000 and duration at least 3 years were 6.21 (95% confidence interval 5.30 to 7.28) and 3.32 (95% confidence interval 2.94 to 3.74).
Conclusion: Claim cost and lost time are related to when and how long opioids are prescribed for work-related injuries.

Source: Lavin, Robert A. MD, MS; Tao, Xuguang (Grant) MD, PhD; Yuspeh, Larry BA; Kalia, Nimisha MD, MPH, MBA; Bernacki, Edward J. MD, MPH. Journal of Occupational & Environmental Medicine: March 2016, Volume 58, Issue 3, p. e90-e93.
http://dx.doi.org/10.1097/JOM.0000000000000625

Effects of graded return-to-work

A propensity-score-matched analysis
Objectives: Graded work exposure is deemed to have a therapeutic effect. In Germany, graded return-to-work (GRTW) is therefore frequently used following a rehabilitation program if workers are still unable to perform full job duties. The aim of the analyses was to determine long-term effects on disability pension and regular employment.
Methods: Analyses were performed with longitudinal administrative data. Patients aged 18–60 years who attended an orthopedic, cardiac, oncological, or psychosomatic rehabilitation between January and June 2007 were eligible to participate in a GRTW scheme. The effects of GRTW were analyzed by a propensity-score-matched comparison of patients with and without GRTW. Outcomes were disability pension rates, regular income, and the duration of receiving welfare benefits due to sickness absence and unemployment up to the end of 2009.
Results: The propensity-score-matched sample comprised 1875 patients on GRTW and 1875 matched controls not undergoing GRTW. The probability of a disability pension was decreased by about 40% among GRTW patients [5.4% versus 8.6%; hazard rate ratio (HR) 0.62, 95% confidence interval (95% CI) 0.49–0.80]. The three-year income (2007–2009) was EUR12 920 higher (95% CI EUR10 054–15 786) in the GRTW group. The duration of receiving welfare benefits due to sickness absence and unemployment was significantly reduced.
Conclusions: Graded work exposure supports labor participation and reduces the risk of permanent work disability.

Source: Bethge M. Scand J Work Environ Health, 2016.
http://dx.doi.org/10.5271/sjweh.3562

Facteurs prédictifs d'une restriction d'aptitude ou d'une inaptitude au poste de travail antérieur en visite de reprise

Élaboration d'un score
L'objectif est d'étudier les facteurs liés à la décision d'aptitude du médecin du travail lors de la visite de reprise d'un salarié après un arrêt de travail pour maladie. Une enquête descriptive multicentrique transversale a été réalisée auprès de 402 salariés suivis par des services de santé au travail (SST) de l'agglomération stéphanoise. La reprise du travail au poste antérieur est significativement liée à certains facteurs professionnels et médicaux. Un score prédictif d'un avis d'aptitude autre que " apte " a été construit en renseignant quatre variables explicatives de l'avis d'aptitude identifiées dans l'analyse multivariée. Ce score pourrait être utilisé pour identifier en amont les situations difficiles de reprise du travail, de manière à mieux anticiper la mise en place des procédures de maintien dans l'emploi.

Source: http://www.rst-sante-travail.fr/rst/pages-article/ArticleRST.html?refINRS=RST.TF%20234

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