Biomedical subjects

Thomas M Wickizer

Publications and source records attributed to Thomas M Wickizer.

4 recordsLinked to original sources

PubMed2003

Comparison of the Roland-Morris Disability Questionnaire and generic health status measures: a population-based study of workers' compensation back injury claimants.

STUDY DESIGN: Workers' compensation back injury claimants completed baseline and follow-up telephone interviews in a prospective population-based cohort study. OBJECTIVE: To compare the Roland-Morris Disability Questionnaire (RDQ) to widely used generic health status measures in a sample of workers with recent work-related back injuries in terms of validity, reliability, responsiveness to change, and floor and ceiling effects. SUMMARY OF BACKGROUND DATA: Little research has directly compared the validity and responsiveness of the RDQ to that of the Short-Form 12 or Short-Form 36 health status measures among individuals with back pain. Furthermore, there is little information concerning the validity, reliability, and responsiveness of the RDQ as a measure of functional outcomes for workers with back injuries. METHODS: Approximately 8 weeks (median) after filing low back injury claims, 309 workers completed the RDQ, Short-Form 12, and Short-Form 36 scales and gave information about their work status in computer-assisted telephone interviews. An average of 5 months later, 284 workers (91.9%) completed the measures again. RESULTS: The RDQ demonstrated excellent internal consistency and validity through correlations with other measures of physical functioning, ability to discriminate between those working and those not working, and much more responsiveness to change than the Short-Form 12 and Short-Form 36 scales. However, 15% of the sample did not answer one or more RDQ items. CONCLUSIONS: The RDQ is a valid measure of physical disability among workers with back injuries. Its greater responsiveness to change suggests its superiority to the Short-Form 12 and Short-Form 36 as an outcome measure in this population.

Adolescent↗

PubMed2003

Employer satisfaction with workers' compensation health care: results of the Washington State Workers' Compensation Managed Care Pilot.

Developing more effective approaches to disability prevention has been a longstanding challenge for the workers' compensation system. A major obstacle to this goal has been the lack of communication and interaction between employers and physicians who care for injured workers. From 1995 through 1997, the Washington State Department of Labor and Industries sponsored a major demonstration program, known as the managed care pilot (MCP), to assess the effects of managed care on medical and disability costs, patient satisfaction and employer satisfaction. We developed a telephone survey and administered it to 243 employers as part of the MCP evaluation. Topics covered in this survey include satisfaction with treatment rendered, duration of lost work time, work modifications, and satisfaction with communication received during the employee's recovery period. Employers in the intervention (managed care) condition were more satisfied with the managed care/occupational medicine system than the employers in the comparison group were with the fee-for-service system. MCP employers were satisfied particularly with the frequency and quality of communication received from the health care provider regarding return to work and work modification issues. Improved employer-provider communication may foster early return to work and thereby have a beneficial effect on health and employment outcomes for injured workers.

Fee-for-Service Plans↗

PubMed2002

Improving the quality of occupational health care in Washington State: new approaches to designing community-based health care systems.

The need for concerted action to improve quality was stressed in the recent Institute of Medicine report, Crossing the Quality Chasm: A New Health Care System for the 21st Century. This article describes an innovative community-based delivery system initiative designed to improve quality and health outcomes for occupational health conditions. Known as the Occupational Health Services (OHS) project, this Washington State initiative focuses on three targeted conditions: low back sprain, carpal tunnel syndrome, and fractures. To fulfill its purpose, which is to provide clinical resources and training opportunities and foster quality improvement activities on a community-wide basis, the OHS incorporates several key delivery system components, including systems to track patient and employer satisfaction and health outcomes; formal physician agreements that will provide incentives for using best-practices; and community-based Centers of Occupational Health and Education (COHEs) that will function as a resource for providers, patients, and employers. Our experience in developing the OHS quality improvement initiative should have relevance for health care clinicians, administrators, policy makers, and researchers engaged in similar pursuits outside the field of occupational health.

Accidents, Occupational↗

PubMed2001

Utilization management: issues, effects, and future prospects.

Utilization management encompasses a diverse set of activities designed to influence the use of health care services and thereby constrain health care resource consumption. Utilization management, which has become one of the most widely used cost-containment approaches, has engendered debate and controversy. Physicians have been outspoken critics of utilization management because it has limited their clinical autonomy and has contributed to an intolerable administrative burden. Insurance carriers, managed care plans, and third-party payers have defended the use of utilization management as an imperfect-but necessary-practice that is needed to reduce consumption of unnecessary or inappropriate health care services. This review examines the operation and effects of three widely used utilization management procedures: prospective utilization review, case management, and physician gatekeeping programs. In addition, it explores the future role of utilization management in the health care system and outlines a set of principles that we believe should be used to guide the development of utilization management strategies in the future.

Cost Control↗