Publications by authors named "Nimisha Kalia"
Background: Rotator cuff repair (RCR) is increasingly being performed for both acute traumatic and degenerative tears of the rotator cuff, whereas total shoulder arthroplasty (TSA) is reserved for osteonecrosis of the humeral head, arthritis of the glenohumeral joint, and failed RCR.
Objective: This study aimed to assess the incidence and patient characteristics of rotator cuff tears (RCTs), RCRs, and TSAs among workers' compensation claimants.
Methods: A total of 8347 RCTs indemnity claims filed to Accident Fund Group from 2007 to 2022 were studied.
Background: Total knee arthroplasty (TKA) is a commonly performed knee surgery and prior arthroscopic meniscectomy (AM) has been linked to an increased risk of TKA in the general population.
Objective: To study the relationship between AM and TKA among injured workers whose medical care is paid for under workers' compensation (WC).
Method: A total of 17,247 lost-time claims depicting all arthroscopic knee surgical procedures performed from 2007 to 2017 were followed to the end of 2022 and analyzed.
Objective: The aim of the study is to determine the morphine equivalent dose in milligrams (MED)/day escalation trend after initial utilization.
Methods: A total of 25,108 lost time claims filed between 1998 and 2007 were followed for 8 years from injury date. Claims were stratified by initial MED/day at 3 months after injury into four groups (0, 1 to < 15, 15 to < 30, and ≥30 MED/day).
Objective: To explore the long-term persistence of COVID-19-related impairment and the ability to work after the acute phase of the illness.
Method: The 19,101 COVID-19 workers' compensation claims filed between January 1, 2020, and December 31, 2021, with follow-up to May 31, 2022, were analyzed.
Results: The average time lost from work decreased from 77 days in the first quarter of 2020 to 9.
Objective: The aim of the study is to determine the associations of workers' compensation claim costs and return to work with drugs prescribed for early symptom management.
Methods: Claims filed from 1998 to 2007 were followed for 10 years from the injury date. Drugs analyzed included gabapentin, pregabalin, antipsychotics, antidepressants, sedatives, benzodiazepines, carisoprodol, and opioids, controlling for initial reserve, sex, age, physical therapy, attorney involvement, and surgery.
Objective: To examine the attributes associated with long duration COVID- 19 workers' compensation (WC) claims.
Methods: A study was conducted on 13,153 COVID-19 WC claims accepted by a workers' compensation insurance carrier between January 1, 2020 and November 30, 2021.
Results: 1) Ninety-five percent of accepted WC claims were closed within the study period; 2) five percent of claims had 30 days or longer of lost time accounting for 65% of total paid WC costs; 3) medical costs increased 8-fold once paid days lost crossed the threshold of 60 days or greater; 4) age was the strongest risk factor associated with increased WC costs and prolonged impairment.
Objective: Bipolar disorder (BD) is a chronic illness with recurrent exacerbations. The objective was to evaluate longitudinal costs related to BD in an employer-sponsored medical plan.
Methods: This analysis utilized 5 years of administrative claims data.
Objective: To determine long term (11 year) trends in gabapentin and pregabalin prescribing among workers' compensation claimants at various opioid dose combinations (low, medium, high, and very high) in Louisiana.
Method: A longitudinal study of 18,737 claimants who filled any prescriptions between 2008 and 2018.
Results: The proportion of claimants prescribed opioids alone at all dose levels decreased dramatically.
Objective: To describe the cost outcomes of an integrated workers' compensation program.
Methods: We studied a population that increased from 20K to 59K, incurring 8807 lost-time claims between 1988 and 2020.
Results: Lost-time claims decreased from 22.
Objective: To evaluate an empirical olfactory test to identify COVID-19 cases during a workplace entrance screening.
Method: An active screening for olfactory dysfunction using water and vinegar was conducted in April to June 2020 among 4120 meat packing workers in Latin America.
Results: The sensitivity and specificity of the active olfactory screening examination were 41.
The COVID-19 pandemic has resulted in a significant increase in accommodation requests from employees seeking temporary alterations to or relief from their job demands. To maintain consistency and ensure a standard approach, Johns Hopkins Medicine established a COVID-19 Accommodation Review committee that includes experts from the occupational health, legal, and human resources departments, as well as an Americans with Disabilities Act coordinator. In this article, the authors describe the workflow and various components of their institution's accommodations review process, which has resulted in a more consistent and equitable approach to granting requests.
View Article and Find Full Text PDFObjective: Determine the industries with the highest proportion of accepted COVID-19 related workers' compensation (WC) claims.
Methods: Study included 21,336 WC claims (1898 COVID-19 and 19,438 other claims) that were filed between January 1, 2020 and August 31, 2020 from 11 states in the Midwest United States.
Result: The overwhelming proportion of all COVID-19 related WC claims submitted and accepted were from healthcare workers (83.
Gabapentinoid and Opioid Utilization and Cost Trends Among Injured Workers.
J Occup Environ Med
February 2021
Objective: To characterize changes in opioid, gabapentin, and pregabalin utilization patterns and cost trends between 2008 and 2018 in a Louisiana workers' compensation claims population and explore the role of gabapentinoids as alternative analgesics during the opioid epidemic.
Method: Filled prescriptions for gabapentinoids and opioids were studied for 11 years in a cohort of 18,737 claimants.
Results: The proportion of claimants prescribed gabapentin increased 2-fold (8.
Objective: To quantify the association between physical therapy (PT) visits and workers' compensation costs and lost time.
Method: A total of 40,203 lost-time claims (1998 to 2018) were analyzed.
Results: The odds ratio of total paid claim costs more than or equal to $100,000 increased with the number of PT visits from 1.
Objective: To determine the rate, characteristics, and costs of Spinal Cord Stimulator (SCS) placements among claimants at a Texas-based workers' compensation carrier.
Methods: Indemnity claims occurring between January 1, 2008 and December 31, 2018 were assessed longitudinally.
Results: While there was annual variability in rates of SCS placement, the rate of SCS placement increased from 0.
: Many large employers utilize on-site medical clinics as a major component of their long-term healthcare cost management strategy. This study aims to quantify on-site clinic return on investment (ROI) associated with the avoidance of direct healthcare expenditures for preventive, urgent care and occupational medical services at an international beverage company. A multivariable linear regression model indicated there was a significant association between the ROI and increasing penetration rates, number of employees, and clinic age (P < 0.
View Article and Find Full Text PDFObjective: The aim of this study was to identify a simple surrogate to predict the future risk of multiple lost-time injuries.
Method: Employees of an academic medical center who sustained 5,906 injuries were followed from 1994 to 2017 or 1,046,218 person years.
Results: The odds ratio of having three or more lost-time injuries during their entire duration of employment was 2.
Background: A significant decrease in back injury claims was observed in a single employer.
Objective: The aim of this study was to validate whether back injury claims are decreasing in a multiemployer environment within a non-monopolistic state and quantify the risk of delayed return-to-work and adverse cost of injured workers with back injuries.
Methods: Thirty-six thousand four hundred sixty-three claims from 1998 to 2015 were analyzed with descriptive statistics and multivariate logistic and Cox-Proportional Hazards models.
Background: Antidepressants, benzodiazapines, and opioid medications are used to manage the pain, anxiety, or depression associated with workplace injuries.
Objective: To evaluate the impact of these medications on workers' compensation costs and time lost from work.
Methods: A cohort of 22,383 indemnity claims from 2008 to 2013 were evaluated for the association of prescribed medications on claim cost and delayed claim closure controlling for confounders.