東華大學圖書館 |

Factors Associated with Service Utilization in Injured Workers in West Virginia.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Factors Associated with Service Utilization in Injured Workers in West Virginia./
作者:	Brown, Brandy.
面頁冊數:	1 online resource (109 pages)
附註:	Source: Dissertations Abstracts International, Volume: 84-03, Section: B.
Contained By:	Dissertations Abstracts International84-03B.
標題:	Emergency medical care. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=29283577click for full text (PQDT)
ISBN:	9798845459251

Factors Associated with Service Utilization in Injured Workers in West Virginia.
Brown, Brandy.

Factors Associated with Service Utilization in Injured Workers in West Virginia. - 1 online resource (109 pages)

Source: Dissertations Abstracts International, Volume: 84-03, Section: B.

Thesis (Ph.D.)--West Virginia University, 2022.

Includes bibliographical references

Introduction: Minimal research has been conducted on healthcare utilization among injured workers residing in rural areas. These workers are often at high risk for work-related injury due to the industries in which they work and commonly experience barriers to accessing healthcare. The first study in this dissertation series explored general characteristics of injured workers receiving care at occupational medicine clinics in West Virginia (WV). The second and third studies explored the moderating effects of rurality, pain medication, and psychiatric medication on sociodemographic and health status factors and number of medical encounters.Methods: Each study used a cross-sectional design with data from the electronic health records of individuals receiving care at any West Virginia University Hospitals affiliated Occupational Medicine clinic over a two-year term (January 1, 2017-December 31, 2019). The outcome variable for all three studies was number of medical encounters - number of visits to the occupational medicine clinic for issues resulting from a work-related injury. Predictor variables for the first study were gender, race, ethnicity, religion, rurality, payor source, smoking status, pain medication, psychiatric medication, location/type of injury, and median severity of injury. Variables that had an alpha value of 0.25 or less in bivariate analyses in the first study were included as predictor variables in the second and third studies. Generalized linear regression with Poisson distribution was completed in each of the studies to determine covariates (first study) and to determine main effects and moderating effects of specified predictor variables (second and third studies). Results: A total of 784 participants received care that accounted for 2,433 encounters over the course of two years. General characteristics of injured workers in WV were somewhat similar to those in other areas with the majority being white (n=746, 96%), non-Hispanic (n=759, 99%), and male (n=466, 59%). However, approximately one third of these workers resided in a rural area and rurality was significantly associated with a decreased number of encounters (p=.0122*). Rurality also had a moderating effect on median severity of injury, worker's compensation, psychiatric medication, and all other injuries. Pain medication and psychiatric medications were also found to moderate some of the predictor variables. The presence of pain medication in the electronic health record had a moderating effect that changed the interaction of psychiatric medication, religious, worker's compensation, upper extremity wound or traumatic injury, and sprain, strain of head/neck/face that either increased or decreased the likelihood of number of encounters. Religious, rural, current smoking status, worker's compensation, pain medication, sprain, strain, or tear of trunk, and upper extremity wound or traumatic injury were moderated by psychiatric medication.Conclusion: The association between number of encounters and the sociodemographic and health status of injured workers in WV is moderated by rurality, and documented pain medication, or psychiatric medication. The impact of rurality and documented medication regimens impacted the predictor variables in slightly different ways demonstrating that the interaction of factors that influence healthcare utilization is complex. It is important to explore these differences to guide programming, support, research, and policy development to optimize healthcare access and utilization for positive return to work outcomes in this population of workers. To do this we need to look at data outside of that provided by the Bureau of Labor Statistics to gain a deeper understanding of the healthcare utilization and return to work processes for injured workers. Utilizing electronic health records data in future studies can guide in the development of programming that addresses whole worker health following reported work-related injury, mitigates barriers to care, and identifies those at risk for increased healthcare costs and long-term disability.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2023

Mode of access: World Wide Web

ISBN: 9798845459251Subjects--Topical Terms:

3563184
Emergency medical care.
Index Terms--Genre/Form:

542853
Electronic books.

Factors Associated with Service Utilization in Injured Workers in West Virginia.
LDR:05643nmm a2200481K 4500 001 2356911
005 20230619080657.5
006 m o d
007 cr mn ---uuuuu
008 241011s2022 xx obm 000 0 eng d
020 $a 9798845459251
035 $a (MiAaPQ)AAI29283577
035 $a (MiAaPQ)WVirginia11324
035 $a AAI29283577
040 $a MiAaPQ $b eng $c MiAaPQ $d NTU
100 1 $a Brown, Brandy. $3 3697425
245 1 0 $a Factors Associated with Service Utilization in Injured Workers in West Virginia.
264 0 $c 2022
300 $a 1 online resource (109 pages)
336 $a text $b txt $2 rdacontent
337 $a computer $b c $2 rdamedia
338 $a online resource $b cr $2 rdacarrier
500 $a Source: Dissertations Abstracts International, Volume: 84-03, Section: B.
500 $a Advisor: Cottrell, Lesley ; Allen, Anna ; Wheeler, Steven ; Gao, Weimin.
502 $a Thesis (Ph.D.)--West Virginia University, 2022.
504 $a Includes bibliographical references
520 $a Introduction: Minimal research has been conducted on healthcare utilization among injured workers residing in rural areas. These workers are often at high risk for work-related injury due to the industries in which they work and commonly experience barriers to accessing healthcare. The first study in this dissertation series explored general characteristics of injured workers receiving care at occupational medicine clinics in West Virginia (WV). The second and third studies explored the moderating effects of rurality, pain medication, and psychiatric medication on sociodemographic and health status factors and number of medical encounters.Methods: Each study used a cross-sectional design with data from the electronic health records of individuals receiving care at any West Virginia University Hospitals affiliated Occupational Medicine clinic over a two-year term (January 1, 2017-December 31, 2019). The outcome variable for all three studies was number of medical encounters - number of visits to the occupational medicine clinic for issues resulting from a work-related injury. Predictor variables for the first study were gender, race, ethnicity, religion, rurality, payor source, smoking status, pain medication, psychiatric medication, location/type of injury, and median severity of injury. Variables that had an alpha value of 0.25 or less in bivariate analyses in the first study were included as predictor variables in the second and third studies. Generalized linear regression with Poisson distribution was completed in each of the studies to determine covariates (first study) and to determine main effects and moderating effects of specified predictor variables (second and third studies). Results: A total of 784 participants received care that accounted for 2,433 encounters over the course of two years. General characteristics of injured workers in WV were somewhat similar to those in other areas with the majority being white (n=746, 96%), non-Hispanic (n=759, 99%), and male (n=466, 59%). However, approximately one third of these workers resided in a rural area and rurality was significantly associated with a decreased number of encounters (p=.0122*). Rurality also had a moderating effect on median severity of injury, worker's compensation, psychiatric medication, and all other injuries. Pain medication and psychiatric medications were also found to moderate some of the predictor variables. The presence of pain medication in the electronic health record had a moderating effect that changed the interaction of psychiatric medication, religious, worker's compensation, upper extremity wound or traumatic injury, and sprain, strain of head/neck/face that either increased or decreased the likelihood of number of encounters. Religious, rural, current smoking status, worker's compensation, pain medication, sprain, strain, or tear of trunk, and upper extremity wound or traumatic injury were moderated by psychiatric medication.Conclusion: The association between number of encounters and the sociodemographic and health status of injured workers in WV is moderated by rurality, and documented pain medication, or psychiatric medication. The impact of rurality and documented medication regimens impacted the predictor variables in slightly different ways demonstrating that the interaction of factors that influence healthcare utilization is complex. It is important to explore these differences to guide programming, support, research, and policy development to optimize healthcare access and utilization for positive return to work outcomes in this population of workers. To do this we need to look at data outside of that provided by the Bureau of Labor Statistics to gain a deeper understanding of the healthcare utilization and return to work processes for injured workers. Utilizing electronic health records data in future studies can guide in the development of programming that addresses whole worker health following reported work-related injury, mitigates barriers to care, and identifies those at risk for increased healthcare costs and long-term disability.
533 $a Electronic reproduction. $b Ann Arbor, Mich. : $c ProQuest, $d 2023
538 $a Mode of access: World Wide Web
650 4 $a Emergency medical care. $3 3563184
650 4 $a Higher education. $3 641065
650 4 $a Personal protective equipment. $3 3685778
650 4 $a Intervention. $3 3435307
650 4 $a Medical personnel. $2 itrt. $3 774747
650 4 $a Injuries. $3 3563044
650 4 $a Health care expenditures. $3 3433801
650 4 $a Accountability. $3 3435301
650 4 $a Medicine. $3 641104
650 4 $a Cocaine. $3 536083
650 4 $a Public health. $3 534748
650 4 $a Pain. $3 533714
650 4 $a Mental depression. $3 3556007
650 4 $a Urban areas. $3 3546012
650 4 $a Nursing. $3 528444
650 4 $a Males. $3 3562279
650 4 $a Clinical psychology. $3 524863
650 4 $a Education. $3 516579
650 4 $a Health care management. $3 2122906
650 4 $a Mental health. $3 534751
650 4 $a Psychology. $3 519075
655 7 $a Electronic books. $2 lcsh $3 542853
690 $a 0573
690 $a 0564
690 $a 0569
690 $a 0745
690 $a 0207
690 $a 0354
690 $a 0622
690 $a 0515
690 $a 0769
690 $a 0629
690 $a 0510
690 $a 0454
690 $a 0347
690 $a 0621
710 2 $a ProQuest Information and Learning Co. $3 783688
710 2 $a West Virginia University. $3 1017532
773 0 $t Dissertations Abstracts International $g 84-03B.
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=29283577 $z click for full text (PQDT)