Early Intervention in Low Back Disability among Coal Miners in West Virginia: Negative Findings

A major issue in the field of workers' compensation is cost containment, not only of medical costs, but of extended disability costs as well. For a 9-month period in 1985 to 1986, the West Virginia Workers' Compensation Fund tested an early intervention case management approach begun withi...

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Bibliographic Details
Published in:Journal of occupational medicine 1990-10, Vol.32 (10), p.1047-1052
Main Authors: Greenwood, Judith G., Wolf, Harvey J., Pearson, R. John C., Woon, Chun Ling, Posey, Patricia, Main, Charles F.
Format: Article
Language:English
Subjects:
Absenteeism
Accidents, Occupational - economics
Adult
Back Injuries
Biological and medical sciences
Coal Mining
Cost Control
Cost-Benefit Analysis
Female
Humans
Injuries of the limb. Injuries of the spine
Male
Medical sciences
ORIGINAL ARTICLES
Regression Analysis
Socioeconomic Factors
Traumas. Diseases due to physical agents
West Virginia
Workers' Compensation
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Summary:A major issue in the field of workers' compensation is cost containment, not only of medical costs, but of extended disability costs as well. For a 9-month period in 1985 to 1986, the West Virginia Workers' Compensation Fund tested an early intervention case management approach begun within 2 weeks after injury and found it not to be cost effective. In a controlled study of 284 reported back injuries among underground coal miners, medical costs increased with the case management intervention, although only to the extent of the added costs of the intervention, and disability costs and time lost from work did not decrease. Permanent partial disability awards, litigation rates, number of hospitalizations, and return to work were similar between both the experimental and control groups. Regression analyses of 25 factors identified factors most highly predictive of disability and medical costs, but in predicting extended disability, although the factors were 100% sensitive, they were only 43.6% specific. The case management approach was insufficient to prevent extended disability or to lower medical costs.
ISSN:0096-1736
2332-3795