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

Hunt, Dan L. DO; Tower, Jack MS; Artuso, Ryan D. PhD; White, Jeffrey A. MS; Bilinski, Craig MS; Rademacher, James BA; Tao, Xuguang MD, PhD; Bernacki, Edward J. MD, MPH

Journal of Occupational and Environmental Medicine: May 2016 - Volume 58 - Issue 5 - p 519–524
doi: 10.1097/JOM.0000000000000718
ORIGINAL ARTICLES

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.

Corporate Claims (Dr Hunt), Medical Center of Excellence (Mr Tower, Dr Artuso, Mr Rademacher), Corporate Administration office, AF Group, Lansing, Michigan (Mr White and Mr Bilinski), Division of Environmental and Occupational Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland (Drs Tao and Bernacki).

Address correspondence to: Edward J. Bernacki, MD, MPH, Professor and Executive Director of Healthcare Solutions, Dell Medical School, The University of Texas at Austin, Concurrently Professor of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205. (ed.bernacki@austin.utexas.edu).

The study received partial funding from AF Group.

The authors have no conflicts of interest.

Copyright © 2016 by the American College of Occupational and Environmental Medicine