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Hospital Qualities Related to Return to Work from Occupational Injury after Controlling for Injury Severity as Well as Occupational Characteristics.

Won JU, Seok H, Rhie J, Yoon JH - J. Korean Med. Sci. (2016)

Bottom Line: Relative risk and 95% confidence interval were calculated using log binomial regression models.The RR (95% CI) in the 2(nd), 3(rd), and 4(th) quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1(st) quartile score, respectively.In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.

View Article: PubMed Central - PubMed

Affiliation: The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea.; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.; Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
We examined associations between hospital quality in the workers' compensation system and injured patients' return to work after controlling for injury severity, occupational factors, and demographic factors. Return to work data of injured workers were constructed from 2 datasets: 23,392 patients injured in 2009-2011 from the Korea Workers' Compensation & Welfare Service and return to work data from Korea Employment Information Services. After de-identifying the data, quality scores were matched for each hospital that cared for injured patients. Injury severity was measured by Abbreviated Injury Scales. Relative risk and 95% confidence interval were calculated using log binomial regression models. After adjusting for age, sex, injury severity, occupation, factory size, city, and hospital type, the relative risk (95% confidence interval) for the total score was 1.04 (1.02-1.06), 1.06 (1.04-1.09), and 1.07 (1.05-1.10) in the 2(nd), 3(rd), and 4(th) quartiles, respectively, compared to the 1(st) quartile. The RR (95% CI) in the 2(nd), 3(rd), and 4(th) quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1(st) quartile score, respectively. In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.

No MeSH data available.


Related in: MedlinePlus

Evaluation items of current study according to Donabedian model.
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Figure 2: Evaluation items of current study according to Donabedian model.

Mentions: Regarding the quality aspects of hospitals focused on workers’ compensation, educated staff conducted a survey from October 2013 to December 2013 at hospitals (n = 485) registered with COMWEL. COMWEL manages the workers’ compensation insurance program in Korea. Evaluations of COMWEL-contracted hospitals have been performed since 2008 (1), and there is an assessment tool to reflect the characteristics of the worker’s compensation medical care system (10). All staffs were educated in a standardized survey process, and 3 staff members including a COMWEL employee, physician, and nurse took the surveys at each hospital. Briefly, the statuses of the infrastructure, staff, and equipment were assessed as the structure quality of the hospital. Diagnoses, treatment, rehabilitation, follow-up activity, and clinical notes made by health care professionals were assessed as the process quality of the hospital. For the outcome quality of the hospital, the rate of closed claims, degree of workers’ compensation system utilization, and patient and health care professional hospital satisfaction were assessed (Fig. 2). The score of each quality aspect and their sum (total score) were calculated (10). The injured patients’ data and RTW statuses were de-identified prior to all data collection to assess hospital quality. If workers had experienced one or more hospitals, the hospital was allotted when the workers closed the claims of workers’ compensation insurance.


Hospital Qualities Related to Return to Work from Occupational Injury after Controlling for Injury Severity as Well as Occupational Characteristics.

Won JU, Seok H, Rhie J, Yoon JH - J. Korean Med. Sci. (2016)

Evaluation items of current study according to Donabedian model.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835593&req=5

Figure 2: Evaluation items of current study according to Donabedian model.
Mentions: Regarding the quality aspects of hospitals focused on workers’ compensation, educated staff conducted a survey from October 2013 to December 2013 at hospitals (n = 485) registered with COMWEL. COMWEL manages the workers’ compensation insurance program in Korea. Evaluations of COMWEL-contracted hospitals have been performed since 2008 (1), and there is an assessment tool to reflect the characteristics of the worker’s compensation medical care system (10). All staffs were educated in a standardized survey process, and 3 staff members including a COMWEL employee, physician, and nurse took the surveys at each hospital. Briefly, the statuses of the infrastructure, staff, and equipment were assessed as the structure quality of the hospital. Diagnoses, treatment, rehabilitation, follow-up activity, and clinical notes made by health care professionals were assessed as the process quality of the hospital. For the outcome quality of the hospital, the rate of closed claims, degree of workers’ compensation system utilization, and patient and health care professional hospital satisfaction were assessed (Fig. 2). The score of each quality aspect and their sum (total score) were calculated (10). The injured patients’ data and RTW statuses were de-identified prior to all data collection to assess hospital quality. If workers had experienced one or more hospitals, the hospital was allotted when the workers closed the claims of workers’ compensation insurance.

Bottom Line: Relative risk and 95% confidence interval were calculated using log binomial regression models.The RR (95% CI) in the 2(nd), 3(rd), and 4(th) quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1(st) quartile score, respectively.In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.

View Article: PubMed Central - PubMed

Affiliation: The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea.; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.; Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
We examined associations between hospital quality in the workers' compensation system and injured patients' return to work after controlling for injury severity, occupational factors, and demographic factors. Return to work data of injured workers were constructed from 2 datasets: 23,392 patients injured in 2009-2011 from the Korea Workers' Compensation & Welfare Service and return to work data from Korea Employment Information Services. After de-identifying the data, quality scores were matched for each hospital that cared for injured patients. Injury severity was measured by Abbreviated Injury Scales. Relative risk and 95% confidence interval were calculated using log binomial regression models. After adjusting for age, sex, injury severity, occupation, factory size, city, and hospital type, the relative risk (95% confidence interval) for the total score was 1.04 (1.02-1.06), 1.06 (1.04-1.09), and 1.07 (1.05-1.10) in the 2(nd), 3(rd), and 4(th) quartiles, respectively, compared to the 1(st) quartile. The RR (95% CI) in the 2(nd), 3(rd), and 4(th) quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1(st) quartile score, respectively. In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.

No MeSH data available.


Related in: MedlinePlus