Prevention, Medical Management, and Adjudication of Workplace Injuries: A Thirty-Two Year Follow-up of an Integrated Workers' Compensation Program.

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 22.15 to 4.32 per 1000 employees (1988 to 2020), and total closed lost-time claim costs per $100 payroll, decreased from $0.62 to $0.17 (1988 to 2017). The percent of claims resolved within 3 years of the accident increased from 10% to 89% (1988 to 2017). Adjusting for medical inflation and wage increases, total workers' compensation benefits paid per claim decreased $124 per year, medical benefits decreased $45 per year and indemnity benefits decreased $79 per year. CONCLUSION: On both a population (per employee) and on a per claim basis, workers' compensation costs decreased substantially, which is attributable to improvements in accident prevention and decreases in claim duration.

Standardizing the Accommodations Process for Health Care Workers During COVID-19.

ABSTRACT: 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.

Assessing Workplace Clinic Utilization and Performance: Lessons and Implications for Care Delivery.

: 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 < 0.0001). Over a 10-year period, while the types of services delivered changed, onsite clinics continued to demonstrate significant and increasing cost savings for this employer.

Do Work-Related Lost-Time Injuries Sustained Early in Employment Predict Multiple Lost-Time Injuries Throughout Employment?

OBJECTIVE: 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 2.12 (95% confidence interval: 1.60 to 2.79) for employees having their first lost-time injury within the first 6 months of employment versus those injured after that, controlling for demographics and employment duration. For each increasing year before the first lost-time injury, the probability of having three or more lost-time injuries decreased by 13%. CONCLUSIONS: Employment duration before the first lost-time injury may be used to predict future lost-time injuries without detailed information of underlying risk factors.