Trends and Disparities in the Use of Telehealth Among Injured Workers During the COVID-19 Pandemic.

OBJECTIVE: To describe telehealth trends within a population-based workers' compensation system during the COVID-19 pandemic, and to assess telehealth utilization by sociodemographic characteristics. METHODS: This cross-sectional study used Washington State workers' compensation claims and medical billing data from January 2019 to October 2020. RESULTS: Telehealth use averaged 1.2% of medical bills pre-pandemic, peaked in April 2020 at 8.8%, and leveled off to around 3.6% from July to October 2020. Telehealth utilization differed significantly by age, sex, number of dependents, injury, industry, and receipt of interpreter services. Workers residing in counties with higher population, lower poverty rates, and greater Internet access had higher telehealth usage. CONCLUSIONS: There were dramatic shifts in telehealth; usage differed by sociodemographic characteristics. Further studies evaluating disparities in tele-health access among injured workers are needed.

Opioid and Benzodiazepine Use Before Injury Among Workers in Washington State, 2012 to 2015.

OBJECTIVE: To characterize pre-injury prescription opioid and benzodiazepine use and its relationship with post-injury use and missed work among workers. METHODS: Three hundred thirteen thousand five hundred forty three Washington State Department of Labor and Industries workers' compensation injury claims from 2012 to 2015 were linked with State Prescription Monitoring Program data. Pre-injury prevalence of opioid and benzodiazepine use were compared between compensable and non-compensable claims, and between workers with and without post-injury prescriptions, using the Pearson's chi-squared test. RESULTS: The prevalence of opioid or benzodiazepine use in the 90 days before injury was 8.6% and 2.9%, respectively. Workers with pre-injury opioid or benzodiazepine use were more likely to have compensable claims and be on opioids or benzodiazepines, respectively, after injury. Cases with chronic opioid use pre-injury nearly universally receive opioids post-injury. CONCLUSIONS: Pre-injury opioid and benzodiazepine use may increase the risk of disability after work-related injury.

Microkeratome complications.

PURPOSE OF REVIEW: Complications from laser in-situ keratomileusis surgery are extremely rare. However, most of the complications involve construction of the corneal flap, which is fashioned using various mechanical or femtosecond laser microkeratomes. Here, we review and discuss complications of microkeratome flaps. RECENT FINDINGS: Several large studies of microkeratome laser in-situ keratomileusis cases report a similar set of complications: partial or irregular flaps, buttonholes, and free flaps. Risk factors for these complications include increased age, preoperative hyperopia, and years of contact lens wear. Numerous animal and clinical studies have shown that the femtosecond platform produces flaps with greater stability with more consistent and accurate dimensions than the mechanical microkeratome. However, there is no significant difference in final visual outcome. SUMMARY: The aim of this review is to report complications associated with mechanical microkeratomes in the construction of laser in-situ keratomileusis flaps and to see whether there is a significant disadvantage compared with the femtosecond laser.