The direct cost burden of 13years of disabling workplace injuries in the U.S. (1998-2010): Findings from the Liberty Mutual Workplace Safety Index.

Introduction: Although occupational injuries are among the leading causes of death and disability around the world, the burden due to occupational injuries has historically been under-recognized, obscuring the need to address a major public health problem.

Methods: We established the Liberty Mutual Workplace Safety Index (LMWSI) to provide a reliable annual metric of the leading causes of the most serious workplace injuries in the United States based on direct workers compensation (WC) costs.

Results: More than $600 billion in direct WC costs were spent on the most disabling compensable non-fatal injuries and illnesses in the United States from 1998 to 2010.

Recurrence of work-related low back pain and disability: association between self-report and workers' compensation data.

Study Design: Retrospective cohort.

Objective: To explore the ability to capture low back pain (LBP) recurrence using wage-replacement (WR) data.

Summary Of Background Data: LBP can be a recurrent, fluctuating, and disabling condition.

Impact of estradiol valerate/dienogest on work productivity and activities of daily living in women with heavy menstrual bleeding.

Objectives: To quantify the change in work productivity and activities of daily living in North American women with heavy menstrual bleeding (HMB) treated with estradiol valerate/dienogest (E2V/DNG; Qlaira(®)/Natazia(®)) compared to placebo.

Methods: Women in the United States and Canada, aged 20-53 years with an objective diagnosis of HMB and no recognizable anatomical pathology, were treated with E2V/DNG or placebo for seven cycles (196 days). Main outcome measures included work productivity (i.

Impact of estradiol-valerate/dienogest on work productivity and activities of daily living in European and Australian women with heavy menstrual bleeding.

Background: The purpose of this study was to quantify the impact of estradiol-valerate/dienogest (E(2)V/DNG; Qlaira(®)/Natazia(®)) on work productivity and activities of daily living in European and Australian women with heavy menstrual bleeding.

Methods: Women aged 18-54 years with a confirmed diagnosis of heavy menstrual bleeding and no recognizable pathology were recruited across nine European countries (the Czech Republic, Finland, Germany, Hungary, The Netherlands, Poland, Sweden, UK, and Ukraine) and Australia. The women were randomized to receive either E(2)V/DNG (n = 149) or placebo (n = 82) for seven treatment cycles (196 days).

Association of disability duration with physical therapy services provided after meniscal surgery in a workers' compensation population.

Objective: To examine the association between physical therapy (PT) amount and type (eg, active exercise and passive modalities) received postmeniscectomy with subsequent days of work disability.

Design: Historical prospective study.

Setting: Workers' compensation administrative claims data source.

Health maintenance care in work-related low back pain and its association with disability recurrence.

Objectives: To compare occurrence of repeated disability episodes across types of health care providers who treat claimants with new episodes of work-related low back pain (LBP).

Method: A total of 894 cases followed 1 year using workers' compensation claims data. Provider types were defined for the initial episode of disability and subsequent episode of health maintenance care.

Workers' perspectives on low back pain recurrence: "it comes and goes and comes and goes, but it's always there".

Although various measures of low back pain (LBP) recurrence have been proposed, none have been tested to determine if they are consistent with what those with LBP perceive a "recurrence" to be. To further the understanding of LBP recurrence and how to measure it, we examined how individuals with a history of LBP describe their back pain experiences. A qualitative approach was chosen and six mixed-gender focus groups were conducted.

In vitro fertilisation with recombinant follicle stimulating hormone requires less IU usage compared with highly purified human menopausal gonadotrophin: results from a European retrospective observational chart review.

Background: Previous studies have reported conflicting results for the comparative doses of recombinant follicle stimulating hormone (rFSH) and highly purified human menopausal gonadotrophin (hMG-HP) required per cycle of in vitro fertilisation (IVF); the aim of this study was to determine the average total usage of rFSH versus hMG-HP in a 'real-world' setting using routine clinical practice.

Methods: This retrospective chart review of databases from four European countries investigated gonadotrophin usage, oocyte and embryo yield, and pregnancy outcomes in IVF cycles (± intra-cytoplasmic sperm injection) using rFSH or hMG-HP alone. Included patients met the National Institute for Health and Clinical Excellence (NICE) guideline criteria for IVF and received either rFSH or hMG-HP.

Modelling the clinical and economic implications of galantamine in the treatment of mild-to-moderate Alzheimer's disease in Germany.

Objective: This analysis was to assess the long-term clinical and economic implications of galantamine in the treatment of mild-to-moderate Alzheimer's disease (AD) in Germany.

Methods: An economic model was developed using discrete event simulation to predict the course of AD through changes in cognition, behavioural disturbance, and function over time. It compares the costs and benefits of galantamine versus no-drug treatment and ginkgo biloba.

Back pain recurrence: an evaluation of existing indicators and direction for future research.

Study Design: Literature review.

Objective: To present a framework for future analyses of back pain recurrence and explore the applicability and relevance of existing recurrence indicators.

Summary Of Background Data: Empirical studies of back pain have included a variety of indicators of recurrence, resulting in a range of findings about recurrence rates and associated factors.

Urban-rural differences in work disability following occupational injury: are they related to differences in healthcare utilization?

Objective: To investigate urban-rural differences in health care utilization following compensable work-related injury and determine whether differences relate to work disability.

Methods: Analysis of worker's compensation data relating to 4889 people with a bone fracture. Regression analyses were used to test the associations between rurality, work disability, and health care utilization.

Urban-rural differences in work disability after an occupational injury.

Objectives: In comparison with their urban counterparts, people living in rural areas have been found to experience higher rates of morbidity and mortality and have inferior health outcomes after illnesses and injuries. The current study sought to determine if this trend extends to work-disability outcomes after work-related injuries.

Methods: This study was a retrospective cohort study using data on workers' compensation claims.

Who's in charge? Challenges in evaluating quality of primary care treatment for low back pain.

Rationale And Objectives: Low back pain (LBP) is a common condition with frequent health care visits and work disability. Quality improvement efforts in primary care focused on guidelines adherence, provider selection and education, and feedback on appropriateness of care. Such efforts can only succeed if a health care provider is in charge of care over a substantial period.

The association between timing and duration of chiropractic care in work-related low back pain and work-disability outcomes.

Objective: To examine the timing and duration of chiropractic care in occupational low back pain (OLBP) and their association with work-disability duration and recurrent disability using workers' compensation (WC) claims data.

Methods: Patients from four states who received chiropractic care for uncomplicated OLBP were identified through WC claims. Univariate and multivariate analyses were used, controlling for utilization of chiropractic care and other factors.

Measuring return to work.

Background: It is argued that one of the factors limiting the understanding of return to work (RTW) following work disability is the use of measurement tools that do not capture a complete picture of workers' RTW experiences. To facilitate the investigation of RTW, the current authors proposed a developmental conceptualization of RTW, which argues for an expanded awareness that encompasses four phases: off work, work reintegration, work maintenance and advancement. This paper reports on work undertaken with the aim of operationalizing the conceptualization.

The impact of procedure type, jurisdiction and other factors in workers' compensation on work-disability outcomes following carpal tunnel surgery.

Carpal tunnel syndrome (CTS) is often work-related and associated with prolonged disability. While surgical treatment is common, an alternative endoscopic procedure has been promoted as a way of achieving better outcomes. However, little is known about typical use of the procedure and whether it actually achieves outcomes in community settings.

Utilization and costs of chiropractic care for work-related low back injuries: do payment policies make a difference?

Background: Chiropractic care is frequently used in the treatment of work-related low back pain. Chiropractors have been shown to be more sensitive to cost-sharing than other providers.

Purpose: This study examined the differences in utilization and costs of chiropractic care for work-related low back injuries in seven jurisdictions and whether these differences can be associated with workers' compensation (WC) payment policies.

Work disability and costs caused by recurrence of low back pain: longer and more costly than in first episodes.

Study Design: Retrospective analysis of workers' compensation (WC) claims data for nonspecific low back injuries (LBI) in a single jurisdiction.

Objective: To examine whether recurrences, defined as post-initial episodes of work disability or medical care, substantially contribute to total medical and indemnity costs, and total duration of work disability.

Summary Of Background Data: Previous studies have not measured the proportion of care seeking and work disability that are associated with recurrences in claims for work-related LBI.

Geographic variation in surgical treatment for work-related carpal tunnel syndrome: does improved return to work matter?

Medical treatment of compensated work-related conditions has two objectives--improve injured workers' health status and allow safe and sustained return to work (RTW). Theoretically, the choice of treatment method should be based primarily on these objectives. Surgical treatment of work-related carpal tunnel syndrome (CTS) provides an opportunity to evaluate whether this occurs.

A developmental conceptualization of return to work.

Introduction: Although return to work (RTW) is a phenomenon that has been researched for many years, our ability to understand and improve outcomes is still limited. As an avenue for advancing the field, this paper presents an alternative way of thinking about RTW.

Method: The conceptualization was constructed based on a review of the literature and the comments of RTW and workers' compensation researchers.

Return-to-work outcomes following work disability: stakeholder motivations, interests and concerns.

Introduction: Satisfaction with return-to-work (RTW) outcomes is dependent on many factors, including a clear exposition of what people define as a "good outcome" and the information they use to determine if such an outcome has been achieved. This paper defines the key stakeholders involved in the RTW process and discusses the need to understand their motivations, interests, and concerns.

Methods: A review of the literature and discussions with RTW researchers conducted by a multidisciplinary group of academic researchers.

Primary care involvement and outcomes of care in patients with a workers' compensation claim for back pain.

Study Design: A retrospective case series of primary care patients receiving Workers' Compensation (WC) for back pain.

Objective: To describe the extent of primary care provider (PCP) involvement in work-related low back pain (WRLBP), and whether PCP involvement is a significant determinant of patterns of care or outcomes.

Summary Of Background Data: In general, WRLBP has inferior outcomes compared with nonoccupational LBP.

Risk factors for recurrent episodes of care and work disability: case of low back pain.

Recurrences of injuries are common and have significant socioeconomic consequences; it is important to identify associated risk factors as potential opportunities for prevention. This study was conducted to identify risk factors for low back pain (LBP) recurrence and the extent that variation in recurrence definition impacts identified risk factors. Patients with new claims for LBP reported in New Hampshire to a workers' compensation provider were selected (n = 2023) with a minimum of 3-year follow up.

Recurrence of low back pain: definition-sensitivity analysis using administrative data.

Study Design: Retrospective analysis of administrative claims data in a single workers' compensation jurisdiction.

Objectives: To evaluate the effects of alternative definitions and follow-up parameters on rates of low back pain recurrence based on detailed administrative data.

Summary Of Background Data: Previous studies reported low back pain recurrence rates ranging from 14% to 45%, without consistency in definitions of recurrence or specifications of follow-up.