Geographic variability of adherence to occupational injury treatment guidelines

Research output: Contribution to journalArticle

Abstract

Objectives: To determine the geographic variability and relationship between six occupational injury practice guidelines.

Methods: Guidelineswere developed by an expert panel and evaluated using workers compensation claims data from a large, national insurance company (1999 to 2010). Percentage compliance for each guideline was adjusted for age and sex using linear regression and mapped by hospital referral region. Regions with the lowest compliance were identified, and correlations between guidelines were calculated.

Results: Compliance to the unnecessary home care guideline showed the lowest geographic variation (interquartile range: 97.3 to 99.0), and inappropriate shoulder bracing showed the highest variation (interquartile range: 77.7 to 90.8). Correlation between the guidelines was weak and not always positive.

Conclusions: Different guidelines showed different degrees of geographic variation. Lack of correlation between guidelines suggests that these indicators were not associated with a single underlying health care quality or patient severity construct.

Original languageEnglish (US)
Pages (from-to)1308-1312
Number of pages5
JournalJournal of Occupational and Environmental Medicine
Volume56
Issue number12
DOIs
StatePublished - Dec 14 2014

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Occupational Injuries
Guidelines
Compliance
Therapeutics
Workers' Compensation
Quality of Health Care
Home Care Services
Insurance
Practice Guidelines
Linear Models
Referral and Consultation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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title = "Geographic variability of adherence to occupational injury treatment guidelines",
abstract = "Objectives: To determine the geographic variability and relationship between six occupational injury practice guidelines.Methods: Guidelineswere developed by an expert panel and evaluated using workers compensation claims data from a large, national insurance company (1999 to 2010). Percentage compliance for each guideline was adjusted for age and sex using linear regression and mapped by hospital referral region. Regions with the lowest compliance were identified, and correlations between guidelines were calculated.Results: Compliance to the unnecessary home care guideline showed the lowest geographic variation (interquartile range: 97.3 to 99.0), and inappropriate shoulder bracing showed the highest variation (interquartile range: 77.7 to 90.8). Correlation between the guidelines was weak and not always positive.Conclusions: Different guidelines showed different degrees of geographic variation. Lack of correlation between guidelines suggests that these indicators were not associated with a single underlying health care quality or patient severity construct.",
author = "Trujillo, {Antonio Jose} and Heins, {Sara E.} and Anderson, {Gerard F} and Castillo, {Renan Carlos}",
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AU - Trujillo, Antonio Jose

AU - Heins, Sara E.

AU - Anderson, Gerard F

AU - Castillo, Renan Carlos

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