Journal of occupational and environmental medicine
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J. Occup. Environ. Med. · Apr 2012
Optimizing health care delivery by integrating workplaces, homes, and communities: how occupational and environmental medicine can serve as a vital connecting link between accountable care organizations and the patient-centered medical home.
In recent years, the health care reform discussion in the United States has focused increasingly on the dual goals of cost-effective delivery and better patient outcomes. A number of new conceptual models for health care have been advanced to achieve these goals, including two that are well along in terms of practical development and implementation-the patient-centered medical home (PCMH) and accountable care organizations (ACOs). At the core of these two emerging concepts is a new emphasis on encouraging physicians, hospitals, and other health care stakeholders to work more closely together to better coordinate patient care through integrated goals and data sharing and to create team-based approaches that give a greater role to patients in health care decision-making. ⋯ Occupational and environmental medicine provides a well-established infrastructure and parallel strategies that could serve as a force multiplier in achieving the fundamental goals of the PCMH model and ACOs. In this paradigm, the workplace-where millions of Americans spend a major portion of their daily lives-becomes an essential element, next to communities and homes, in an integrated system of health anchored by the PCMH and ACO concepts. To be successful, OEM physicians will need to think and work innovatively about how they can provide today's employer health services-ranging from primary care and preventive care to workers' compensation and disability management-within tomorrow's PCMH and ACO models.
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J. Occup. Environ. Med. · Apr 2012
Workers' compensation benefits and shifting costs for occupational injury and illness.
Whereas national prevalence estimates for workers' compensation benefits are available, incidence estimates are not. Moreover, few studies address which groups in the economy pay for occupational injury and illness when workers' compensation does not. ⋯ Incidence estimates of national benefits for workers' compensation were generated by combining existing published data. Costs were shifted to workers and their families, non-workers' compensation insurance carriers, and governments.
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J. Occup. Environ. Med. · Mar 2012
Identification of work-related injuries in a State Trauma Registry.
Many state trauma registries contain work-related information but are underutilized for occupational injury research/surveillance. We assessed three methods of identifying work-related injuries in the Washington State Trauma Registry (WTR). ⋯ The WTR work-related indicator is highly sensitive and may identify injuries that occur in the course of exempt/excluded employment, are not reported to workers' compensation, and/or are work-related using definitions that go beyond WC coverage. Judicious use of external cause codes may identify additional work-related injuries.
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J. Occup. Environ. Med. · Feb 2012
Increases in the use and cost of opioids to treat acute and chronic pain in injured workers, 1999 to 2009.
Quantify temporal changes in opioid use. ⋯ The annual cumulative dose and cost of opioids per claim increased over the study period related to an increase in prescriptions for long-acting opioids.