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Claim Records (claim + record)
Selected AbstractsPost-tooth extraction sepsis without locoregional infection , a population-based study in TaiwanORAL DISEASES, Issue 8 2009J-J Lee Objective:, To investigate the incidence and risk factors of post-tooth extraction sepsis in patients without locoregional infection. Subjects and Methods:, We assessed all claim records of the Taiwanese National Health Insurance program in 2005. Admissions for patients aged ,16 years containing a discharge diagnosis of sepsis, and who received tooth extraction within 14 days before the admission were identified. Patient charts were reviewed to confirm the diagnosis of sepsis and rule out other infection sources. The relationship between postextraction sepsis (PES) and clinical parameters was analyzed. Results:, Thirty-three of the 2 223 971 extraction cases met the criteria of PES, an incidence of 1.48 per 100 000, and seven patients (21.2%) died of the disease. Aging significantly increased the risk of PES (P < 0.001). Pre-existing comorbidities were found in 20 of the 33 cases, with diabetes mellitus and hematologic diseases the most common. The method, number, and position of extraction had no influence on PES incidence. Blood cultures were positive in 25 patients (75.8%) and isolates included species of the Streptococcus, Actinomyces, Klebsiella, Bacteroides, Prevotella, and Enterococcus genera. Conclusion:, Tooth extraction is associated with a low but significant risk of postoperative sepsis, especially in the elderly and patients with underlying diseases. [source] Ergonomic and socioeconomic risk factors for hospital workers' compensation injury claimsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 7 2009Jon Boyer ScD Abstract Background Hospital workers are a diverse population with high rates of musculoskeletal disorders (MSDs). The risk of MSD leading to workers' compensation (WC) claims is likely to show a gradient by socioeconomic status (SES) that may be partly explained by working conditions. Methods A single community hospital provided workforce demographics and WC claim records for 2003,2005. An ergonomic job exposure matrix (JEM) was developed for these healthcare jobs from direct observation of physical workload and extraction of physical and psychosocial job requirements from the O*NET online database. Occupational exposures and SES categories were assigned to workers through their O*NET job titles. Univariate and multivariate Poisson regression analyses were performed to estimate the propensity to file an injury claim in relation to individual factors, occupational exposures, and SES. Results The jobs with the highest injury rates were nurses, semi-professionals, and semi-skilled. Increased physical work and psychological demands along with low job tenure were associated with an increase in risk, while risk decreased with psychosocial rewards and supervisor support. Both occupational and individual factors mediated the relationship between SES and rate of injury claims. Conclusions Physical and organizational features of these hospital jobs along with low job tenure predicted WC injury claim risk and explained a substantial proportion of the effects of SES. Further studies that include lifestyle risk factors and control for prior injuries and co-morbidities are warranted to strengthen the current study findings. Am. J. Ind. Med. 52:551,562, 2009. © 2009 Wiley-Liss, Inc. [source] Medical Expenditures during the Last Year of Life: Findings from the 1992,1996 Medicare Current Beneficiary SurveyHEALTH SERVICES RESEARCH, Issue 6 2002Donald R Hoover Objective. To compare medical expenditures for the elderly (65 years old) over the last year of life with those for nonterminal years. Data Source. From the 1992,1996 Medicare Current Beneficiary Survey (MCBS) data from about ten thousand elderly persons each year. Study Design. Medical expenditures for the last year of life and nonterminal years by source of payment and type of care were estimated using robust covariance linear model approaches applied to MCBS data. Data Collection. The MCBS is a panel survey of a complex weighted multilevel random sample of Medicare beneficiaries. A structured questionnaire is administered at four-month intervals to collect all medical costs by payer and service. Medicare costs are validated by claims records. Principal Findings. From 1992 to 1996, mean annual medical expenditures (1996 dollars) for persons aged 65 and older were $37,581 during the last year of life versus $7,365 for nonterminal years. Mean total last-year-of-life expenditures did not differ greatly by age at death. However, non-Medicare last-year-of-life expenditures were higher and Medicare last-year-of-life expenditures were lower for those dying at older ages. Last-year-of-life expenses constituted 22 percent of all medical, 26 percent of Medicare, 18 percent of all non-Medicare expenditures, and 25 percent of Medicaid expenditures. Conclusions. While health services delivered near the end of life will continue to consume large portions of medical dollars, the portion paid by non-Medicare sources will likely rise as the population ages. Policies promoting improved allocation of resources for end-of-life care may not affect non-Medicare expenditures, which disproportionately support chronic and custodial care. [source] More evidence of the need for an ergonomic standardAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2004Jeff Biddle Abstract Background In 1999, the Occupational Safety and Health Administration (OSHA) proposed regulations designed to reduce work related inquiries by limiting worker exposure to "ergonomic risk factors." Congress subsequently overturned the regulations. We provide additional evidence on earnings losses attributable to musculoskeletal disorders (MSDs), and thus on the need for an ergonomic standard. Methods Regression techniques are used to analyze data from a survey of injured workers that has been matched to employer-reported earnings data covering pre- and post-injury periods, and to workers' compensation claims records. Results MSDs lead to large and persistent earnings losses. Cost estimates used by OSHA to justify the 1999 EPS are corroborated. Losses are greatest among workers who file workers compensation claims, but nonclaimants also have losses. Conclusions Earnings losses and lost productivity associated with work-related MSDs are substantial and an ergonomic standard could be cost effective. Am. J. Ind. Med. 45:329,337, 2004. © 2004 Wiley-Liss, Inc. [source] | ||||||||||