A New Method of Assessing the Impact of Evidence-Based Medicine on Claim Outcomes.

OBJECTIVE: The objective of this study is to develop a method of quantifying compliance with Evidence-Based Medicine (EBM) guidelines as a means of assessing the relationship between the use of EBM guidelines and illness absence and costs in workers' compensation. METHODS: A total of 45,951 indemnity claims with two years of development filed between 2008 and 2013 were utilized to develop the methodology. RESULTS: The newly developed methodology adequately assessed the relationship between claim outcomes (duration and medical incurred) and adherence to EBM guidelines, controlling for medical complexity, distinct number of International Classification of Diseases (ICD)-9 codes, and other confounding factors. CONCLUSIONS: The compliance score described in this paper may be a useful tool for determining the impact of worker's compensation treatment guidelines on claim outcomes.

The effect of opioid use on workers' compensation claim cost in the State of Michigan.

OBJECTIVE: To investigate the association between opioid utilization and catastrophic claim (≥$100,000) cost. METHOD: A total of 12,226 workers' compensation indemnity claims that were opened and closed from January 1, 2006 to February 28, 2010 in the State of Michigan were selected for multivariate logistic regression analyses. RESULT: Controlling for sex, age, claim duration, number of distinct International Classification of Diseases-Ninth Revision codes per claim, and legal involvement, the presence of short-acting opioids on a claim were 1.76 (95% confidence interval: 1.23 to 2.51) and long-acting opioids 3.94 (95% confidence interval: 2.35 to 6.89) more likely to have a final cost $100,000 or more than a claim without any prescription. CONCLUSION: The use of opioid medications, particularly long-acting opioid medications, is an independent risk factor for the development of catastrophic claims.