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A New Method of Assessing the Impact of Evidence-Based Medicine on Claim Outcomes
Dan L Hunt1, Jack Tower, Ryan D Artuso
1Corporate Claims (Dr Hunt), Medical Center of Excellence (Mr Tower, Dr Artuso, Mr Rademacher), Corporate Administration office, AF Group, Lansing, Michigan (Mr White and Mr Bilinski), Division of Environmental and Occupational Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland (Drs Tao and Bernacki).
Objective:
The objective of this study is to develop a method of quantifying compliance with Evidence-Based Medicine (EBM) guidelines as a means of assessing the relationship between the use of EBM guidelines and illness absence and costs in workers' compensation.
Methods:
A total of 45,951 indemnity claims with two years of development filed between 2008 and 2013 were utilized to develop the methodology.
Results:
The newly developed methodology adequately assessed the relationship between claim outcomes (duration and medical incurred) and adherence to EBM guidelines, controlling for medical complexity, distinct number of International Classification of Diseases (ICD)-9 codes, and other confounding factors.
Conclusions:
The compliance score described in this paper may be a useful tool for determining the impact of worker's compensation treatment guidelines on claim outcomes.
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