J Occup Environ Med. 2017 (Dec 26) [Epub] ~ FULL TEXT
Cristina Demian; Bruce Barron; Anthony Almudevar
Department of Environmental Medicine,
University of Rochester Medical Center
OBJECTIVE: Examine the association between New York State Workers' Compensation Medical Treatment Guidelines (Guidelines) adherence and return-to-work after occupational low back injuries. Assess adherence to Guidelines by examining diagnostic and treatment utilization.
METHOD: Retrospective chart review of cases. Outcomes of interest were lost time duration and diagnostic/treatment utilization rates. Time to event analyses performed using Kaplan Meier plots and Cox proportional hazard model.
RESULTS: Care received after implementation of Guidelines resulted in decreased lost time. Treatment rates were consistent, while diagnostic imaging use was inconsistent with Guidelines recommendations.
CONCLUSIONS: Guidelines use positively influenced return-to-work after acute occupational low back injuries. Inconsistencies in following Guidelines were observed for diagnostic tests, having a potential paradoxical effect on lost time. Further studies are necessary to test for additional hypotheses.