Biomedical subjects

Edward J Bernacki

Publications and source records attributed to Edward J Bernacki.

6 recordsLinked to original sources

PubMed2006

An assessment of universal versus risk-based hepatitis C virus testing of source patients postexposure to blood and body fluids among healthcare workers.

OBJECTIVE: The objective of this study was to assess the impact of universal versus risk-based hepatitis C (HCV) testing of source patients' (SPs) postexposure to blood and body fluids on the HCV exposure rates among healthcare workers. METHODS: Exposure and test result information between 1993 and 2004 was abstracted from the Johns Hopkins Bloodborne Pathogen Database. A Poisson regression model estimating HCV infection among underlying SPs based on partial testing was developed and applied. RESULTS: After adjusting for the effect of partial testing of SPs, the estimated underlying prevalence of HCV-positive SPs increased slightly during the study period, from 11.9% to 15.1%, but the trend was not statistically significant. Yield curve of HCV-positive SPs rose quickly when SPs' testing rates were low but became flat when SPs' testing rates were high. CONCLUSION: Reliance on HCV risk factors to screen SPs resulted in an underestimation of the prevalence of HCV in SPs before 1997 when the testing rates were between 15.4% and 25.6%. When SPs' testing rates were above 65%, our model predicted no additional yield of HCV-positive SPs.

Blood↗

PubMed2006

An investigation of the effects of a healthcare provider network on costs and lost time in workers' compensation.

OBJECTIVE: The objective of this study was to evaluate the number of lost time days and cost of workers' compensation claims at a median claim duration (maturity) of 25 months for individuals injured between August 1, 2003, and July 31, 2004, who chose a statewide (Louisiana) network (Omnet Gold) of healthcare providers not subject to utilization review. METHODS: We identified and contrasted 176 lost time claims (143 closed) managed by Omnet Gold (OG) healthcare providers and 1464 lost time claims managed by healthcare providers not participating in OG. RESULTS: The average frequency of lost workdays for a closed OG claim was 53 days versus 99 days for a closed non-OG claim and the average cost of a closed OG claim was 12,554 dollars, whereas the average cost of a closed non-OG claim was 20,400 dollars. Both days lost from work and costs were significantly lower among claims managed by OG healthcare providers. This outcome was consistent with the findings of a previous study performed on the same claims in which a significant difference was demonstrated analyzing primarily open (unresolved) claims with a median claim duration of 6 months. The ability of OG healthcare providers to return a higher proportion of injured workers to work early and shorten claims durations were the major factors influencing these outcomes. CONCLUSIONS: In a state where claimants are permitted choice of medical provider, a network of healthcare providers can achieve superior lost time and cost outcomes than out of network healthcare providers.

Disability Evaluation↗

PubMed2005

A randomized clinical trial of continuous low-level heat therapy for acute muscular low back pain in the workplace.

OBJECTIVES: We sought to compare the therapeutic benefits of ThermaCare Heat Wrap combined with an education program to an education-only program on reducing pain and disability from acute work-related low back pain. METHODS: Forty-three eligible patients, aged 20 to 62 years who presented to an occupational injury clinic, were randomized into one of two intervention arms: 1) education regarding back therapy and pain management alone or 2) education regarding back therapy and pain management combined with three consecutive days of topical heat therapy (104 degrees F or 40 degrees C for 8 hours). The primary endpoints in this trial were measures of pain intensity and pain relief levels obtained approximately four times per day for the three consecutive working days of treatment, followed by measures of pain intensity and pain relief levels obtained in three follow-up visits at day 4 and 14 from treatment initiation. The secondary measures were overall impairment due to injury and disability caused by low back pain assessed at Intake, Visit 2 (day 4), 3 (day 7), and 4 (day 14). RESULTS AND CONCLUSION: A total of 18 individuals enrolled in the education-only group and 25 in the treatment group completed the intervention and all follow-up visits. The general linear model adjusting for age, sex, baseline pain intensity, and pain medication indicated that the topical heat therapy had significantly reduced pain intensity, increased pain relief, and improved disability scores during and after treatment.

Acute Disease↗

PubMed2005

A preliminary investigation of the effects of a provider network on costs and lost-time in workers' compensation.

OBJECTIVE: We sought to compare lost-time days and average and median workers' compensation claims costs between injured workers managed by OMNET Gold (OG) physicians and those managed by physicians not participating in OG. OG is a statewide health care provider network coordinated by occupational medicine physicians and established by the Louisiana Workers' Compensation Corporation (LWCC) to manage the medical care of injured workers. METHODS: We identified and contrasted 158 lost-time claims managed by OG physicians and 1,323 claims managed by physicians not participating in OG during the first year of network operation (August 1, 2003 to July 31, 2004). RESULTS: The average and median costs for a non-OG claim was $12,542 and $5,793, whereas the average and median costs for an OG claim was $6,749 and $3,015. The average and median number of lost-time days for an OG claim was 53.4 and 34.0 and 95.0 and 58.0 for a non-OG claim. The mean differences were statistically significant. CONCLUSIONS: A small network of physicians may have an effect on the duration of lost-time and workers' compensation costs.

Absenteeism↗

PubMed2004

Factors influencing the costs of workers' compensation.

This article presents several factors believed to have shaped the costs of workers' compensation. Of these factors, the most notable influence on claims severity is related to the way medical care is delivered to treat occupational injuries and illnesses. Although medical care providers may have some influence on the other factors responsible for increased claims severity, such as attorney costs and differences in state workers' compensation laws, they have a tremendous impact on the way medical care is delivered and its resultant costs. This places physicians, nurse practitioners,physical therapists, chiropractors, nurses, and physician assistants in a unique role of being able to assist US business in improving productivity through a reduction in workers' compensation costs.

Age Factors↗

PubMed2003

Ten years' experience using an integrated workers' compensation management system to control workers' compensation costs.

This work presents 10 years of experience using an Integrated Workers' Compensation Claims Management System that allows safety professionals, adjusters, and selected medical and nursing providers to collaborate in a process of preventing accidents and expeditiously assessing, treating, and returning individuals to productive work. The hallmarks of the program involve patient advocacy and customer service, steerage of injured employees to a small network of physicians, close follow-up, and the continuous dialogue between parties regarding claims management. The integrated claims management system was instituted in fiscal year 1992 servicing a population of approximately 21,000 individuals. The system was periodically refined and by the 2002 fiscal year, 39,000 individuals were managed under this paradigm. The frequency of lost-time and medical claims rate decreased 73% (from 22 per 1000 employees to 6) and 61% (from 155 per 1000 employees to 61), respectively, between fiscal year 1992 and fiscal year 2002. The number of temporary/total days paid per 100 insureds decreased from 163 in fiscal year 1992 to 37 in fiscal year 2002, or 77%. Total workers' compensation expenses including all medical, indemnity and administrative, decreased from $0.81 per $100 of payroll in fiscal year 1992 to $0.37 per $100 of payroll in fiscal year 2002, a 54% decrease. More specifically, medical costs per $100 of payroll decreased 44% (from $0.27 to $0.15), temporary/total, 61% (from $0.18 to $0.07), permanent/partial, 63% (from $0.19 to $0.07) and administrative costs, 48% ($0.16 to $0.09). These data suggests that workers' compensation costs can be reduced over a multi-year period by using a small network of clinically skilled health care providers who address an individual workers' psychological, as well as physical needs and where communication between all parties (e.g., medical care providers, supervisors, and injured employees) is constantly maintained. Furthermore, these results can be obtained in an environment in which the employer pays the full cost of medical care and the claimant has free choice of medical provider at all times.

Accidents, Occupational↗