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Economic Evaluation Of Injury And Injury Prevention Interventions In The U.S. Fire ServiceGriffin, Stephanie Christine January 2014 (has links)
Previous research has shown that firefighters and emergency services personnel are at increased risk of fatal and non-fatal occupational injury compared to other U.S. workers. Analyses of injury and workers’ compensation claims data in this population has demonstrated that injuries are both common and an economic burden on the fire service, especially those caused by overexertion and that lead to sprains/strains. The increased risk of injury is associated with specific job tasks, including physical exercise, patient transport and fireground work, and with personal characteristics such as physical fitness. The economic evaluation of injury and injury prevention can help inform decision making on the part of leadership, including the identification and evaluation of potential targets for injury prevention programs. The aims of the current study were to: 1) evaluate a fitness intervention for new firefighters in terms of health, fitness, injury outcomes as well as workers’ compensation claims costs; 2) to analyze workers’ compensation claims data for trends in cause and injury type, as well as the effect of worker age; and 3) to model the expected change in back injury frequency and costs among emergency medical services personnel following the implementation of electrically powered stretchers. Primary data for the current study, including injury surveillance and workers’ compensation claims data, were provided by the Tucson Fire Department (TFD), Tucson, Arizona. The Probationary Firefighter Fitness Program (PFF-Fit) was designed by University of Arizona researchers in partnership with TFD. The program was implemented in the 2012 recruit academy. Outcomes, including measures of health and fitness, injury, workers’ compensation claim frequency and claims costs, were measured over 17 consecutive months for the intervention class, and compared to outcomes from controls comprised of the three most recent TFD recruit classes for the same time period. Comparing the intervention class to controls, health and fitness outcomes were statistically equivalent. The intervention group experienced statistically significantly fewer injuries, filed significantly fewer claims, and accrued aggregated claims costs approximately $33,000 less than the controls with an estimated equivalent reduction in indirect costs for a total of $66,000. The program implementation costs were nearly $69,000, leading to a one-year return on investment of -0.52 if based only on direct costs (workers’ compensation claims) or -0.048 if an estimate of indirect costs is included. Injury in the U.S. fire service has been the subject of many previous studies but the pattern of workers’ compensation claims has been studied much less frequently. Specifically, the effect of increasing worker age on the frequency and cost of claims has not been studied in this population. Routine injury surveillance and workers’ compensation data from TFD were merged and costs were described by mechanism of injury, injury type, body region and by age of the worker. The analysis of claims data shows that acute overexertion injuries are significantly more costly than injuries caused by other mechanisms, and that sprain/strain injuries are significantly costlier than other injury types. Results also show that age is an important predictor of claims cost in this population, with claims costs for firefighters over age 50, 120 to 144% greater than claims for workers under age 30. Back injury is common and costly among emergency services employees, including firefighters and emergency medical services providers, who transport patients. Previous research has demonstrated that electrically powered stretchers (EPS), which lift and lower the patient and stretcher between the loading and transport positions, are an effective means of reducing back injury among emergency medical services (EMS) providers, but to date no economic evaluation of this device has been conducted. A Markov decision analysis model simulation of a cohort of emergency services employees for incident back injury, disability and associated costs was used to compare outcomes with and without the use of the EPS. Implementation of the EPS resulted in an average cost savings of $4,617-$5,422 per emergency services employee over the service life of the equipment. Results of the current study show the PFF-Fit program may be a worthwhile program to reduce injury and claims costs but further research is needed to better understand the program’s potential effectiveness. We observed reductions in injury frequency and compensation costs among PFF-Fit program participants compared to controls; however, the mechanisms by which the PFF-Fit program were believed to be effective did not appear to be responsible for this difference. Workers’ compensation claims data analysis results continue to highlight the importance of targeting injuries caused by acute overexertion and injuries that result in sprain/strain. The results also indicate that targeting injury prevention efforts toward the specific needs of older workers may lead to important cost savings for the fire service. The EPS is likely an effective intervention to reduce back injuries and claims costs among fire and emergency services personnel, but further research is needed to evaluate injury and claims costs following implementation at several departments.
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Identifying high-risk claims within the Workers' Compensation Board of British Columbia's claim inventory by using logistic regression modelingUrbanovich, Ernest 05 1900 (has links)
The goal of the project was to use the data in the Workers' Compensation Board (WCB) of
British Columbia's data warehouse to develop a statistical model that could predict on an
ongoing basis those short-term disability (STD) claims that posed a potential high financial risk
to the WCB. We were especially interested in identifying factors that could be used to model the
transition process of claims from the STD stratum to the vocational rehabilitation (VR) and long
term disability (LTD) strata, and forecast their financial impact on the WCB. The reason for this
focus is that claims experiencing these transitions represent a much higher financial risk to the
WCB than claims that only progress to the health care (HC) and/or the short term disability
(STD) strata.
The sample used to investigate the conversion processes of claims consists of all STD claims
(323,098) that had injury dates between January 1, 1989 and December 31, 1992. Although high-risk
claims represent only 4.2 % of all STD claims, they have received 64.3% ($1.2 billion) of
the total payments and awards ($1.8 billion) made to July 1999. Low-risk claims make up 95.8%
of all the claims but only receive 35.7% ($651 million) of the payments and awards. Moreover,
the average cost of high-risk claims ($86,200) is 41 times higher than the average cost of low-risk
claims ($2,100).
The main objective of the project was to build a reliable statistical model to identify high-risk
claims that can be readily implemented at the WCB and thereby improve business decisions. To
identify high-risk claims early on, we used logistic regression modeling. Since ten of the most
frequently observed injury types make up 95.72% of all the claims, separate logistic regression
models were built for each of them. Besides injury type, we also identified STD days paid and
age of claimant as statistically significant predictors. The logistic regression models can be used
to identify high-risk claims prior to or at the First Final STD payment date provided we know the
injury type, STD days paid and age of claimant. The investigation showed that the more STD
days paid and the older the injured worker, the higher the probability of the claim being high-risk.
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Scheduling customer service representatives for the Workers’ Compensation Board of British ColumbiaSanegre, Rafael 11 1900 (has links)
The Workers' Compensations Board of British Columbia (WCB) operates 4 call centers in
the province devoted to compensation services. This thesis describes a review of operations
at the call center in the head office, located in Richmond, B.C. We identified the need for a
mathematical model to schedule telephone operators (called CSRs in WCB) in order to
minimize the workforce required, while assuring minimal staffing levels to provide good
customer service. We developed two integer programming models and built an interface that
would enable the supervisors to use the model interactively. We compared the results from
the model to one of their schedules and found that the model used 5 fewer CSRs than
currently in their schedule. The potential savings derived from such a test convinced
management that WCB needed to acquire and implement software to schedule staff.
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Developing and testing an effective interactive voice response (IVR) system for the Workers’ Compensation Board of British ColumbiaMehra, Gaurav 05 1900 (has links)
This thesis was the result of a study conducted for the call-centre at the Workers'
Compensation Board of British Columbia (WCB). The management at WCB wanted to
understand the nature and pattern of calls at their newly opened call-centre. The purpose
of this was to provide an efficient customer service while streamlining the flow of calls
coming to the call-centre.
An extensive data collection exercise was undertaken at the call-centre and two other
units of WCB with which the call-centre interacts. The data analysis revealed that a
high proportion of calls were related to transfers to these departments. There were also
calls related to routine inquiries on claim payment cheques and forms that could
potentially be handled by a well designed IVR system.
Based on this understanding the development of an effective IVR system was proposed to
address the problems that were discovered through documenting the nature and pattern of
calls. An extensive review of literature was undertaken to design a new system according
to the standard industry guidelines suggested by the best practices and customized to
WCB's business needs. Two alternate scripts were developed after analysing the source
and purpose of calls to WCB. One was 'person specific' and the other was 'task specific'.
The two scripts were tested on students at WCB through a computer-based IVR
simulation. The results of the student survey provided evidence that introducing
additional options and use of simple and clear instructions in the new scripts could
potentially in fact address the problems discovered in the study and they were preferred
over the existing WCB script. The IVR simulation is reconfigurable and can be used in
future studies to gather further evidence in support of the results obtained in this thesis as
well as refine scripts before putting them in a production mode.
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The association between compensation and outcome after injuryHarris, Ian A. January 2006 (has links)
Thesis (Ph. D.)--Discipline of Surgery, Faculty of Medicine, University of Sydney, 2007. / Title from title screen (viewed June 28, 2007). Includes tables and questionnaires. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Discipline of Surgery, Faculty of Medicine. Degree awarded 2007; thesis submitted 2006. Includes bibliography. Also issued in print.
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Karoshi and the politics of workers' compensation in JapanNorth, Robert Scott. January 1994 (has links)
Thesis (M.A.)--University of Hawaii, 1994. / Includes bibliographical references (leaves 114-121).
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Impact of fee schedules and approved doctor's list on physician availability in the Texas Workers' Compensation Program.Peck, Kay E. Delclos, George L., Hacker, Carl S., January 2008 (has links)
Thesis (Ph. D.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0972. Adviser: Charles Begley. Includes bibliographical references.
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Loss of earning capacity: its nature and its place in South African lawMillard, Daleen 10 June 2008 (has links)
Loss of earning capacity is a concept that is relevant to actions in which a wrongdoer is held liable for the detrimental effect of his actions on a claimant’s capacity to generate an income.Take the example of a claimant who had worked as a shift leader in a mine but after a damage-causing event is only capable of working above ground as a clerk. By comparing his salary pre-morbid with his salary post-morbid, it is possible to calculate the difference. This difference, if the former is the greater, constitutes the damage suffered by the claimant and, as such, the amount constitutes what he can claim as compensation.In an instance where a person is not in a position to furnish evidence about his earnings pre- and post-morbid, nevertheless, the court may award compensation for the claimant’s loss of earnings.Essentially, the compensation is payment for loss of earning capacity and not for loss of earnings.In making such an award, the court recognises that the claimant experiences a partial or total impairment of his capacity to generate an income.Koch states that in such problematic cases the courts often shy away from quantifying a claimant’s estimated annual income.Instead of employing the sum-formula approach,the courts opt for a general assessment using the “some-how-or-other” approach.What seems at first like a straightforward pre- and post-morbid calculation therefore is fraught with intricate theoretical questions. Although this problem is more evident in cases of unemployed claimants and children, it may also occur in other cases where loss of earning capacity is one of the heads of damages. / Prof. J.W.G. Van der Walt
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Scheduling customer service representatives for the Workers’ Compensation Board of British ColumbiaSanegre, Rafael 11 1900 (has links)
The Workers' Compensations Board of British Columbia (WCB) operates 4 call centers in
the province devoted to compensation services. This thesis describes a review of operations
at the call center in the head office, located in Richmond, B.C. We identified the need for a
mathematical model to schedule telephone operators (called CSRs in WCB) in order to
minimize the workforce required, while assuring minimal staffing levels to provide good
customer service. We developed two integer programming models and built an interface that
would enable the supervisors to use the model interactively. We compared the results from
the model to one of their schedules and found that the model used 5 fewer CSRs than
currently in their schedule. The potential savings derived from such a test convinced
management that WCB needed to acquire and implement software to schedule staff. / Business, Sauder School of / Graduate
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Identifying high-risk claims within the Workers' Compensation Board of British Columbia's claim inventory by using logistic regression modelingUrbanovich, Ernest 05 1900 (has links)
The goal of the project was to use the data in the Workers' Compensation Board (WCB) of
British Columbia's data warehouse to develop a statistical model that could predict on an
ongoing basis those short-term disability (STD) claims that posed a potential high financial risk
to the WCB. We were especially interested in identifying factors that could be used to model the
transition process of claims from the STD stratum to the vocational rehabilitation (VR) and long
term disability (LTD) strata, and forecast their financial impact on the WCB. The reason for this
focus is that claims experiencing these transitions represent a much higher financial risk to the
WCB than claims that only progress to the health care (HC) and/or the short term disability
(STD) strata.
The sample used to investigate the conversion processes of claims consists of all STD claims
(323,098) that had injury dates between January 1, 1989 and December 31, 1992. Although high-risk
claims represent only 4.2 % of all STD claims, they have received 64.3% ($1.2 billion) of
the total payments and awards ($1.8 billion) made to July 1999. Low-risk claims make up 95.8%
of all the claims but only receive 35.7% ($651 million) of the payments and awards. Moreover,
the average cost of high-risk claims ($86,200) is 41 times higher than the average cost of low-risk
claims ($2,100).
The main objective of the project was to build a reliable statistical model to identify high-risk
claims that can be readily implemented at the WCB and thereby improve business decisions. To
identify high-risk claims early on, we used logistic regression modeling. Since ten of the most
frequently observed injury types make up 95.72% of all the claims, separate logistic regression
models were built for each of them. Besides injury type, we also identified STD days paid and
age of claimant as statistically significant predictors. The logistic regression models can be used
to identify high-risk claims prior to or at the First Final STD payment date provided we know the
injury type, STD days paid and age of claimant. The investigation showed that the more STD
days paid and the older the injured worker, the higher the probability of the claim being high-risk. / Business, Sauder School of / Graduate
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