Managed care techniques are becoming increasingly available to manage the medical and indemnity losses associated with injuries paid for under the workers'compensation system.
The authors describe 3 years'experience of identifying and abating workplace hazards and medically managing cases utilizing a preferred provider organization established solely for workers'compensation cases.
In the model described, the occupational physician/nurse case-management team coordinates the entire process, from prevention of accidents to facilitated return to work.
During the study period (1992 to 1995), per-capita losses were reduced by 23%, from $241 in fiscal year 1992 (the year before the managed care initiative), to $185 in fiscal year 1995. (Hereafter, each year referred to indicates that fiscal year.) In 1992,22 lost-time cases per 1000 employees occurred, whereas the number of lost-time cases in the years 1993 to 1995 averaged 12 to 14 per 1000 employees.
The rate of « medical only » cases dropped significantly from 155 per 1000 in 1992 to 96 per 1000 in 1995.
The per-capita amount of monies spent on medical care decreased from $81 in 1992 to $63 in 1995.
The most significant savings in medical costs related to claims associated with new occupational injuries, injuries that occurred during the fiscal year.
In 1992, the per-capita loss on such cases was $23 and in 1995 it was $13, a 43% decrease. (...)
Mots-clés Pascal : Soin intégré, Médecine travail, Diminution coût, Economie santé, Prévention, Indemnité dédommagement, Réhabilitation, Accident travail, Organisation santé, Système santé, Etats Unis, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Managed care, Occupational medicine, Cost lowering, Health economy, Prevention, Indemnity, Rehabilitation, Occupational accident, Public health organization, Health system, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0062226
Code Inist : 002B30B03. Création : 21/05/1997.