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1.
J Occup Environ Med ; 62(9): 692-699, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32890206

RESUMO

: COVID-19 illness can cause multiorgan illness. Some States have passed legislation granting a rebuttable presumption of causation by workplace exposure in certain occupations. This paper summarizes methodology for evaluating claimants utilizing known science and as well as information from the American Medical Association Guides resources.


Assuntos
Betacoronavirus , Infecções por Coronavirus/economia , Doenças Profissionais/economia , Exposição Ocupacional , Pandemias/economia , Pneumonia Viral/economia , Indenização aos Trabalhadores/organização & administração , Infecções por Coronavirus/etiologia , Infecções por Coronavirus/terapia , Humanos , Doenças Profissionais/etiologia , Doenças Profissionais/terapia , Pneumonia Viral/etiologia , Pneumonia Viral/terapia , Estados Unidos
2.
Occup Environ Med ; 77(12): 818-821, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32967988

RESUMO

INTRODUCTION: The SARS-CoV-2 pandemic is an impacting challenge for occupational health. Epidemiological surveillance of COVID-19 includes systematic tracking and reporting of the total cases and deaths, but suitable experiences of surveillance systems for identifying the occupational risk factors involved in the COVID-19 pandemic are still missing, despite the interest for occupational safety and health. METHODS: A methodological approach has been implemented in Italy to estimate the occupational risk of infection, classifying each economic sector as at low, medium-low, medium-high and high risk, based on three parameters: exposure probability, proximity index and aggregation factor. Furthermore, during the epidemic emergency, the Italian Workers' Compensation Authority introduced the notation of COVID-19 work-related infection as an occupational injury and collected compensation claims of workers from the entire national territory. RESULTS: According to compensation claims applications, COVID-19 infection in Italy has been acquired at the workplace in a substantial portion of the total cases (19.4%). The distribution of the economic sectors involved is coherent with the activities classified at risk in the lockdown period. The economic sectors mostly involved were human health and social work activities, but occupational compensation claims also include cases in meat and poultry processing plants workers, store clerks, postal workers, pharmacists and cleaning workers. CONCLUSIONS: There is a need to go towards an occupational surveillance system for COVID-19 cases, including an individual anamnestic analysis of the circumstances in which the infection is acquired, for the prevention of occupational infectious risk, supporting insurance system effectiveness and managing vaccination policies.


Assuntos
Infecções por Coronavirus , Exposição Ocupacional , Saúde do Trabalhador , Ocupações , Pandemias , Pneumonia Viral , Indenização aos Trabalhadores , Local de Trabalho , Adulto , Comércio , Infecções por Coronavirus/epidemiologia , Feminino , Indústria Alimentícia , Pessoal de Saúde , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais , Pneumonia Viral/epidemiologia , Vigilância da População , Serviços Postais , Fatores de Risco , Assistentes Sociais
3.
BMC Public Health ; 20(1): 1463, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993607

RESUMO

BACKGROUND: Healthcare facilities are notorious for occupational health and safety problems. Multi-level interventions are needed to address interacting exposures and their overlapping origins in work organization features. Worker participation in problem identification and resolution is essential. This study evaluates the CPH-NEW Healthy Workplace Participatory Program (HWPP), a Total Worker Health® protocol to develop effective employee teams for worker safety, health, and wellbeing. METHODS: Six public sector, unionized healthcare facilities are enrolled, in three pairs, matched by agency. The unit of intervention is a workplace health and safety committee, adapted here to a joint labor-management "Design Team" (DT). The DT conducts root cause analyses, prioritizes problems, identifies feasible interventions in light of the constraints and needs of the specific setting, makes business-case presentations to facility leadership, and assists in evaluation. Following a stepped-wedge (cross-over) design, one site in each pair is randomly assigned to "immediate intervention" status, receiving the full coached intervention at baseline; in the "lagged intervention" site, coaching begins about half-way through the study. Program effectiveness and cost-effectiveness outcomes are assessed at both organizational (e.g., workers' compensation claim and absenteeism rates, perceived management support of safety) and individual levels (e.g., self-rated health, sleep quality, leisure-time exercise). Targeted pre-post analyses will also examine specific outcomes appropriate to the topics selected for intervention. Process evaluation outcomes include fidelity of the HWPP intervention, extent of individual DT member activity, expansion of committee scope to include employee well-being, program obstacles and opportunities in each setting, and sustainability (within the available time frame). DISCUSSION: This study aims for a quantitative evaluation of the HWPP over a time period long enough to accomplish multiple intervention cycles in each facility. The design seeks to achieve comparable study engagement and data quality between groups. We will also assess whether the HWPP might be further improved to meet the needs of U.S. public sector healthcare institutions. Potential challenges include difficulty in pooling data across study sites if Design Teams select different intervention topics, and follow-up periods too short for change to be observed. TRIAL REGISTRATION: ClinicalTrials.gov NCT04251429 (retrospectively registered January 29, 2020), protocol version 1.


Assuntos
Promoção da Saúde/métodos , Saúde do Trabalhador/estatística & dados numéricos , Engajamento no Trabalho , Local de Trabalho/organização & administração , Análise Custo-Benefício , Exercício Físico , Humanos , Grupos Populacionais , Avaliação de Programas e Projetos de Saúde/métodos , Estudos Prospectivos , Indenização aos Trabalhadores
4.
S Afr Med J ; 110(5): 389-395, 2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32657723

RESUMO

BACKGROUND: Given the elevated risk of tuberculosis (TB), including drug-resistant disease, experienced by health workers in South Africa (SA), effective workers' compensation for occupational TB is a legal right and an essential social benefit. OBJECTIVES: To investigate the experience of the workers' compensation system among health workers who suffered from TB while working in public service facilities in Western Cape Province, SA. METHODS: In this case series with a qualitative component, 300 claims for occupational TB in health workers were sampled from the provincial health department database of claims submitted. Claim status for each case was ascertained. An attempt was made to contact each health worker for a telephonic interview consisting of both closed- and open-ended (qualitative) questions. Fifty-one interviews were completed. RESULTS: In nearly half of the cases, there was no record of claim status on the state Compensation Fund website. Of the 51 interviewees, only one had received all the compensation benefits for their particular claim circumstances. Health workers' experience of having their cases reported for compensation purposes was marred by perception of poor communication and administration. The experience of contracting TB was further characterised by surprise, perceptions of stigma, financial burden and ongoing ill-health. CONCLUSIONS: Affected health workers' experience of the workers' compensation system was mostly negative, adding to the burden of being ill with TB. Education of management and clinicians, improvement in communication, and timeous and regular checking of claim status and of payment of applicable compensation are required at the provincial level. Dedicated facility-based occupational health units are needed, with a staff complement of knowledgeable persons trusted by their colleagues. However, the effectiveness of the system is ultimately dependent on the ability of the Compensation Fund to register and display claims timeously and administer compensation expeditiously.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Tuberculose/epidemiologia , Indenização aos Trabalhadores/estatística & dados numéricos , Adulto , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/economia , Exposição Ocupacional/economia , Exposição Ocupacional/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , África do Sul/epidemiologia , Indenização aos Trabalhadores/economia
5.
Occup Environ Med ; 77(9): 637-647, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32636331

RESUMO

OBJECTIVES: The objective of this historical cohort study was to determine the claimant and prescriber factors associated with receiving opioids at first postinjury dispense compared with non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs) in a sample of workers' compensation claimants with low back pain (LBP) claims between 1998 and 2009 in British Columbia, Canada. METHODS: Administrative workers' compensation, prescription and healthcare data were linked. The association between claimant factors (sociodemographics, occupation, diagnosis, comorbidities, pre-injury prescriptions and healthcare) and prescriber factors (sex, birth year, specialty) with drug class(es) at first dispense (opioids vs NSAIDs/SMRs) was examined with multilevel multinomial logistic regression. RESULTS: Increasing days supplied with opioids in the previous year was associated with increased odds of receiving opioids only (1-14 days OR 1.62, 95% CI 1.51 to 1.75; ≥15 days OR 5.12, 95% CI 4.65 to 5.64) and opioids with NSAIDs/SMRs (1-14 days OR 1.49, 95% CI 1.39 to 1.60; ≥15 days OR 2.82, 95% CI 2.56 to 3.12). Other significant claimant factors included: pre-injury dispenses for NSAIDs, SMRs, antidepressants, anticonvulsants and sedative-hypnotics/anxiolytics; International Statistical Classification of Diseases and Related Health Problems, 9th Revision diagnosis; various pre-existing comorbidities; prior physician visits and hospitalisations; and year of injury, age, sex, health authority and occupation. Prescribers accounted for 25%-36% of the variability in the drug class(es) received, but prescriber sex, specialty and birth year did not explain observed between-prescriber variation. CONCLUSIONS: During this period in the opioid crisis, early postinjury dispensing was multifactorial, with several claimant factors associated with receiving opioids at first prescription. Prescriber variation in drug class choice appears particularly important, but was not explained by basic prescriber characteristics.


Assuntos
Analgésicos Opioides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Dor Lombar/tratamento farmacológico , Fármacos Neuromusculares/uso terapêutico , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Lesões nas Costas/tratamento farmacológico , Colúmbia Britânica , Estudos de Coortes , Comorbidade , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/tratamento farmacológico , Indenização aos Trabalhadores
6.
BMC Public Health ; 20(1): 844, 2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32493252

RESUMO

BACKGROUND: This study aimed to develop a Korean version of the Return-to-Work Self-Efficacy (RTWSE)-19 Scale using forward- and backward-translation and investigate the validity of the RTWSE Scale specifically for Korean workers with work-related injuries. METHODS: Participants were 202 injured workers who had filed a claim accepted by the workers' compensation system and had received medical rehabilitation at workers' compensation hospitals following a work-related musculoskeletal injury. Among these participants, 88.1% were male, 54.5% were over 45 years, 45.5% were manufacturing employees, and 54.5% were craft or machine operator and assemblers. The 19 item RTWSE-19 scale was developed by Shaw et al. and have three underlying subscales: (i) meeting job demands, (ii) modifying job tasks, and (iii) communicating needs to others. Statistical analysis included exploratory factor analysis (maximum likelihood estimation with oblique quartimin rotation), internal consistency reliability using Cronbach's alpha, and correlations with related measures: pain intensity; fear-avoidance beliefs; general health; depression; and general self-efficacy. RESULTS: Using exploratory factor analysis, three factors with 17 items were identified: meeting job demands, modifying job tasks, and communicating needs to others. The removal of two items in the modifying job tasks domain resulted in an increased reliability. The Korean version of the RTWSE-17 showed reasonable model fit (CFI = .963; TLI = .943; RMSEA = .068; SRMR = 0.029), satisfactory reliability (r = 0.925), no floor and ceiling effect, and construct validity. CONCLUSIONS: The Korean RTWSE-17 scale was found to possess good psychometric properties and could address different injury types ranging from fractures to amputations involved in sub-acute and rehabilitation phases in the Korean context. This study's findings provide insights for practitioners and researchers to return to work after rehabilitation in a Korean clinical and workplace setting.


Assuntos
Traumatismos Ocupacionais/psicologia , Escalas de Graduação Psiquiátrica/normas , Retorno ao Trabalho/psicologia , Autoeficácia , Avaliação da Capacidade de Trabalho , Adulto , Comparação Transcultural , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/reabilitação , Psicometria , Reprodutibilidade dos Testes , República da Coreia , Traduções , Indenização aos Trabalhadores , Adulto Jovem
7.
Artigo em Inglês | MEDLINE | ID: mdl-32503223

RESUMO

Health workers globally are at elevated occupational risk of tuberculosis infection and disease. While a raft of guidelines have been published over the past 25 years on infection prevention and control (IPC) in healthcare, studies in different settings continue to show inadequate implementation and persistence of risk. The aim of this commentary is to argue, based on the literature and our own research, that a comprehensive occupational health approach is an essential complement to IPC guidelines. Such an approach includes a health system framework focusing on upstream or mediating components, such as a statutory regulation, leadership, an information system, and staff trained in protective disciplines. Within the classical prevention framework, primary prevention needs to be complemented by occupational health services (secondary prevention) and worker's compensation (tertiary prevention). A worker-centric approach recognises the ethical implications of screening health workers, as well as the stigma perceived by those diagnosed with tuberculosis. It also provides for the voiced experience of health workers and their participation in decision-making. We argue that such a comprehensive approach will contribute to both the prevention of occupational tuberculosis and to the ability of a health system to withstand other crises of infectious hazards to its workforce.


Assuntos
Doenças Profissionais , Saúde do Trabalhador , Tuberculose , Pessoal de Saúde , Humanos , Controle de Infecções , Indenização aos Trabalhadores
8.
J Occup Health ; 62(1): e12118, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32515883

RESUMO

OBJECTIVES: This study aimed to characterize injuries and illnesses among construction workers in the State of Oregon in the US and examine the association between injury frequency and severity with hour of work by using Workers' Compensation (WC) accepted disabling claims data in the construction industry from 2007 to 2013. METHODS: Injury frequency, rate, medical cost, and lost work days were analyzed by year, demographics, employment, injury nature, and temporal factors including hour of work. Multiple linear regression models were used to quantify adjusted associations between hour of work and medical cost and lost work days (indicating injury severity). RESULTS: There were a total of 12 222 disabling claims in the Oregon construction industry. The average annual injury rate was 2.21 per 100 workers. Both the count and rate of disabling claims decreased during the study period. Male workers and young workers had higher injury rates, while medical cost and lost work days increased for older workers. Injuries occurring at night were more severe. The distribution of claims frequency by hour of work was bimodal, with peaks in the 4th and 8th hour. Compared with the first hour of work, the 5th and 13th hours corresponded to significantly more severe injuries and illnesses. CONCLUSIONS: This study identified the burden and distribution of work-related injuries and illnesses in the Oregon construction industry. Continued intervention efforts should target certain subpopulations (eg, young workers) and certain working time periods (eg, mid- and end-shift) to protect construction workers' safety and health.


Assuntos
Indústria da Construção/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Traumatismos Ocupacionais/estatística & dados numéricos , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Indenização aos Trabalhadores/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oregon , Adulto Jovem
9.
PLoS One ; 15(6): e0233599, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555636

RESUMO

Increasing intensification in swine production has led to new and specialized technologies, but the occupational health and safety impacts are rarely quantified in the business plans for adoption. Needle-less injection has potential to increase productivity and eliminate needle stick injury in workers, but it is not clear whether these benefits offset high capital investment and potential increases in musculoskeletal loads. This economic evaluation employed probabilistic scenario analysis using injury, cost, and production data gathered from interviews with swine producers in Manitoba and Saskatchewan. After adoption of needle-less injection, rates of needle-stick injury went down with no measureable effect on upper limb musculoskeletal disorders, resulting in lower health and safety costs for needle-less injectors. Needle-less injection duration was 40% faster once workers acclimatized, but large start-up costs mean economic benefits are realized only after the first year. The incremental benefit cost ratio promoted adoption of needle-less injectors over conventional needles for the base case of a 1200 sow barn; the conventional method is beneficial for barns with 600 sows or less. Findings indicate that well-designed technologies have the potential to achieve the dual ergonomics goals of enhancing human wellbeing and system performance. We anticipate that the economic and decision models developed in this study can be applied to other new technologies in agriculture and animal production.


Assuntos
Criação de Animais Domésticos/organização & administração , Injeções a Jato/veterinária , Saúde do Trabalhador/economia , Local de Trabalho/organização & administração , Criação de Animais Domésticos/economia , Criação de Animais Domésticos/estatística & dados numéricos , Animais , Análise Custo-Benefício , Eficiência Organizacional , Humanos , Injeções a Jato/economia , Manitoba , Ferimentos Penetrantes Produzidos por Agulha/economia , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Doenças Profissionais/economia , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle , Saúde do Trabalhador/estatística & dados numéricos , Saskatchewan , Sus scrofa , Suínos , Doenças dos Suínos/tratamento farmacológico , Doenças dos Suínos/prevenção & controle , Fatores de Tempo , Indenização aos Trabalhadores/economia , Indenização aos Trabalhadores/estatística & dados numéricos , Local de Trabalho/economia
11.
Am J Sports Med ; 48(7): 1559-1567, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32406765

RESUMO

BACKGROUND: Arthroscopic rotator cuff repair (ARCR) is one of the most commonly performed orthopaedic surgical procedures; however, patient-reported outcomes have varied greatly in the literature. PURPOSE: To identify preoperative factors that affect outcomes and to develop prognostic tools for predicting functional outcomes in future ARCR cases. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients were included who underwent ARCR for repairable full-thickness rotator cuff tears with at least 2 years of follow-up. Twelve predictors were entered as candidate predictors in each model: age, sex, workers' compensation (WC) status, previous cuff repair, tear size, tear shape, multiple-tendon involvement, tendon stump length, Goutallier classification, critical shoulder angle, length of follow-up, and baseline subjective outcomes score. Postoperative American Shoulder and Elbow Surgeons (ASES), 12-Item Short Form Health Survey Physical Component Summary (SF-12 PCS), QuickDASH (short version of Disabilities of the Arm, Shoulder and Hand), and patient satisfaction were each modeled through proportional odds ordinal logistic regression. Model results were presented with marginal covariate effect plots and predictive nomograms. RESULTS: Overall, 552 shoulders fit inclusion criteria. The mean age at surgery was 60.2 years (range, 23-81 years). Twenty-five (4.5%) shoulders underwent revision cuff repair or reverse arthroplasty at a mean 1.9 years (range, 0.1-7.9 years) postoperatively. Overall, 509 shoulders were eligible for follow-up, and minimum 2-year postoperative patient-reported outcomes were obtained for 449 (88.2%) at a mean 4.8 years (range, 2-11 years). The ASES score demonstrated significant improvement from pre- to postoperative median (interquartile range): 58 (44.9-71.6) to 98.3 (89.9-100; P < .001). Women demonstrated significantly higher 2-year reoperation rates than men (5.8% vs 1.6%; odds ratio, 2.8 [95% CI, 0.73-9.6]; P = .023). Independently significant predictors for lower postoperative ASES scores included previous ARCR (P < .001), female sex (P < .001), and a WC claim (P < .001). Significant predictors for worse QuickDASH scores included WC claim (P < .001), female sex (P < .001), previous ARCR (P = .007), and ≥7 years of follow-up time. Significant predictors for lower SF-12 PCS scores included WC claim (P < .001), female sex (P = .001), and lower baseline SF-12 PCS. Last, significant independent predictors of patient satisfaction included previous ARCR (P = .004), WC claim (P = .011), female sex (P = .041), and age (P = .041). CONCLUSION: Excellent clinical outcomes and low failure rates were obtained after ARCR by using careful patient selection and modern surgical techniques for ARCR. Female sex, WC claim, and previous ARCR were significant predictors of poorer outcomes in at least 3 patient-reported outcome models. Prognostic nomograms were developed to aid in future patient selection, clinical decision making, and patient education.


Assuntos
Artroscopia , Modelos Biológicos , Lesões do Manguito Rotador , Manguito Rotador , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Nomogramas , Medidas de Resultados Relatados pelo Paciente , Desempenho Físico Funcional , Manguito Rotador/cirurgia , Lesões do Manguito Rotador/cirurgia , Resultado do Tratamento , Indenização aos Trabalhadores , Adulto Jovem
12.
Artigo em Inglês | MEDLINE | ID: mdl-32365961

RESUMO

The present study aimed to present and validate the Worker´s Healthcare Assistance Model (WHAM), which includes an interdisciplinary approach to health risk management in search of integral and integrated health, considering economic sustainability. Through the integration of distinct methodological strategies, WHAM was developed in the period from 2011 to 2018, in a workers' occupational health centre in the oil industry in Bahia, Brazil. The study included a sample of 965 workers, 91.7% of which were men, with a mean age of 44.9 years (age ranged from 23 to 73 years). The Kendall rank correlation coefficient and hierarchical multiple regression analysis were used for the validation of WHAM. The assessment of sustainable return on investment (S-ROI) was made using the WELLCAST ROI™ decision support tool, covering workers with heart disease and diabetes. WHAM can be considered an innovative healthcare model, as there is no available comparative model. WHAM is considered robust, with 86% health risk explanatory capacity and with an 85.5% S-ROI. It can be concluded that WHAM is a model capable of enhancing the level of workers' health in companies, reducing costs for employers and improving the quality of life within the organization.


Assuntos
Investimentos em Saúde , Saúde do Trabalhador , Qualidade de Vida , Indenização aos Trabalhadores , Adulto , Idoso , Brasil , Feminino , Humanos , Indústrias , Masculino , Pessoa de Meia-Idade , Adulto Jovem
13.
J Shoulder Elbow Surg ; 29(9): 1783-1788, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32359714

RESUMO

BACKGROUND: There remains a paucity of studies examining the impact of workers' compensation (WC) on a variety of outcomes after biceps tenodesis. The purpose of this study was to compare the postoperative recovery curves after biceps tenodesis in patients with and without WC claims. METHODS: Using the Surgical Outcomes System database, we assessed the postoperative recovery outcomes of all patients who had outcomes recorded at least 6 months after isolated biceps tenodesis for the treatment of a diagnosis of biceps tendinitis, stratified by WC status. The outcomes analyzed included visual analog scale, American Shoulder and Elbow Surgeons, VR-12 (Veterans RAND 12 Item Health Survey) mental and physical, Simple Shoulder Test, and Single Assessment Numeric Evaluation scores. RESULTS: Overall, 139 patients with WC claims underwent isolated biceps tenodesis vs. 786 patients without WC claims. Demographic characteristics and comorbidities were similar in the 2 groups. Patients without WC claims had significantly improved visual analog scale, VR-12, American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, and Simple Shoulder Test scores at all times points after 3 months and 1 year compared with patients with WC claims. CONCLUSIONS: On analysis of patients' recovery after isolated biceps tenodesis, WC claims led to significantly worse pain and functional outcomes at every time point of analysis (3, 6, 12, and 24 months). Furthermore, patients with WC claims had worse preoperative-to-postoperative improvements in most outcomes. This information can be used to educate surgeons and patients on postoperative expectations, as well as to perform analyses focused on health economics, value, and policy.


Assuntos
Músculo Esquelético/cirurgia , Dor Pós-Operatória , Recuperação de Função Fisiológica , Tendinopatia/cirurgia , Tenodese/métodos , Indenização aos Trabalhadores , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Período Pós-Operatório , Estudos Retrospectivos , Ombro/cirurgia , Articulação do Ombro/cirurgia , Resultado do Tratamento , Escala Visual Analógica
14.
Prof Case Manag ; 25(5): 267-284, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32452940

RESUMO

OBJECTIVES: This is the second of a 2-part article that discusses essential case management practices and strategies amidst the novel coronavirus disease 2019 (COVID-19). The series showcases the potential professional case managers have in support of managing during a crisis such as a global pandemic. Part II continues to describe reenvisioned roles and responsibilities of case managers and their leaders to meet the needs of patients/support systems during the crisis. It focuses on the increased need for end-of-life care, impact on workers' compensation case management practice, and the self-care needs of the professional case manager. PRIMARY PRACTICE SETTINGS: Applicable to the various case management practice settings across the continuum of health and human services, with special focus on acute care. FINDINGS/CONCLUSIONS: The COVID-19 global pandemic has resulted in a crisis case managers and other health care professionals never faced something like it before. At the same time, it has provided opportunities for innovation and creativity including use of digital and telecommunication technology in new ways to ensure the continued delivery of health and human services to those who need them regardless of location. It has also resulted in the development of necessary and impactful partnerships within and across different health care organizations and diverse professional disciplines. Most importantly, this pandemic has required special attention to the increased need of patients for timely palliative and end-of-life care. In addition, it has prompted a focus on the safety, health, and well-being of case managers and other health care professionals, resulting in expanded workers' compensation case management practice coupled with the need for self-care and resilience. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Professional case managers are integral members of interprofessional health care teams. Their roles and responsibilities are even more necessary during the uncertainty of a global pandemic such as COVID-19. So far, the experience of this crisis has resulted in a deliberate need to ensure the safety of both, those who are the recipients of health care services and those who are responsible for the provision of care. Self-care and resilience of health care professionals and case managers, especially due to the complex dynamics of the COVID-19 pandemic, have advanced a desirable and necessary view of remote/virtual practice and as a strategy for enhancing the person's health and well-being. This pandemic has forced the development of impactful partnerships and collaborations among the diverse contexts of health care organizations and support service providers. These contexts of care delivery have also emphasized the necessary legal and ethical practice of case managers and the other involved parties. Experts agree that the innovative care delivery methods practiced during the pandemic will undoubtedly remain as desirable beyond the current crisis period.


Assuntos
Betacoronavirus/isolamento & purificação , Administração de Caso , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Resiliência Psicológica , Assistência Terminal , Indenização aos Trabalhadores , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Humanos , Incidência , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Assistência Terminal/ética , Estados Unidos/epidemiologia , Indenização aos Trabalhadores/ética
16.
Health Aff (Millwood) ; 39(6): 936-941, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-47750

RESUMO

To contain the novel coronavirus disease (COVID-19) pandemic, health and government authorities have imposed sweeping self-quarantine orders for communities worldwide. Health officials assume that the public will have high rates of compliance. However, studies suggest that a major obstacle to compliance for household quarantine is concern about loss of income. A cross-sectional study of the adult population of Israel was conducted in the last week of February 2020 to assess public attitudes toward the COVID-19 outbreak. In particular, public compliance rates with self-quarantine were assessed, depending on whether lost wages would be compensated for. When compensation was assumed, the compliance rate was 94 percent. When compensation was removed, the compliance rate dropped to less than 57 percent. This study demonstrated that providing people with assurances about their livelihoods during self-quarantine is an important component of compliance with public health regulations.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Cooperação do Paciente/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Saúde Pública , Quarentena/organização & administração , Indenização aos Trabalhadores/economia , Adulto , Fatores Etários , Betacoronavirus , Controle de Doenças Transmissíveis/organização & administração , Estudos Transversais , Feminino , Humanos , Renda , Israel , Masculino , Pessoa de Meia-Idade , Pandemias/estatística & dados numéricos , Opinião Pública , Medição de Risco , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Indenização aos Trabalhadores/estatística & dados numéricos
18.
Occup Environ Med ; 77(9): 648-653, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32332060

RESUMO

OBJECTIVES: To examine the impact of workplace injury on opioid dependence, abuse and overdose (opioid-related morbidity) and if severity of injury increases the hazard of these health effects. METHODS: We used MarketScan databases to follow injured and propensity score matched non-injured workers, both without prior opioid-related diagnoses. Using a Cox proportional hazard model, we examined the impact of workplace injury on opioid-related morbidity. RESULTS: The hazard of opioid-related morbidity for injured workers was 1.79 times than that of matched non-injured workers (95% CI 1.89 to 3.60). For medical-only and lost-time injured workers, it was respectively 1.54 (95% CI 1.02 to 2.32) and 2.91 (95% CI 1.75 to 4.84) times that of non-injured workers. CONCLUSIONS: Reducing workplace injury or severity of workplace injury, as well as efforts to ensure appropriate opioid prescribing for injured workers, may help to reduce the societal costs of opioid use.


Assuntos
Overdose de Drogas/epidemiologia , Traumatismos Ocupacionais/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Adulto , Feminino , Humanos , Drogas Ilícitas , Seguro Saúde , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Estudos Retrospectivos , Estados Unidos/epidemiologia , Indenização aos Trabalhadores/estatística & dados numéricos
20.
Health Aff (Millwood) ; 39(6): 936-941, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32271627

RESUMO

To contain the novel coronavirus disease (COVID-19) pandemic, health and government authorities have imposed sweeping self-quarantine orders for communities worldwide. Health officials assume that the public will have high rates of compliance. However, studies suggest that a major obstacle to compliance for household quarantine is concern about loss of income. A cross-sectional study of the adult population of Israel was conducted in the last week of February 2020 to assess public attitudes toward the COVID-19 outbreak. In particular, public compliance rates with self-quarantine were assessed, depending on whether lost wages would be compensated for. When compensation was assumed, the compliance rate was 94 percent. When compensation was removed, the compliance rate dropped to less than 57 percent. This study demonstrated that providing people with assurances about their livelihoods during self-quarantine is an important component of compliance with public health regulations.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Cooperação do Paciente/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Saúde Pública , Quarentena/organização & administração , Indenização aos Trabalhadores/economia , Adulto , Fatores Etários , Betacoronavirus , Controle de Doenças Transmissíveis/organização & administração , Estudos Transversais , Feminino , Humanos , Renda , Israel , Masculino , Pessoa de Meia-Idade , Pandemias/estatística & dados numéricos , Opinião Pública , Medição de Risco , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Indenização aos Trabalhadores/estatística & dados numéricos
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