Speeding diagnosis and saving money using point of care ultrasound rather than MRI for work-related MSK injuries.

Details

• Personal Author:
  Jeffries JA
• Description:
  This descriptive retrospective cohort study utilized a large workers comp insurer database. All MRI's performed on peripheral joints during calendar year 2017 that were (a) 2 weeks after the initial clinic visit, or (b) greater than 6 weeks after injury, but (c) not more than 3 months after the date of injury were evaluated in this study. Individual diagnoses rendered on MRI reports for these cases were categorized as to whether ultrasound alone or ultrasound + xray could adequately provide the same diagnoses. Results showed that, ultrasound + xray would be able to provide all of the same diagnoses compared to MRI in 54% of cases vs 33% of cases using ultrasound alone, highlighting the utility of using ultrasound and xray together. The proportion of cases where ultrasound + xray could reasonably be substituted for MRI increases to 70% overall when less severe diagnoses, considered not likely to change management, were excluded from analysis. If point of care ultrasound was performed for all 1482 cases with subsequent MRIs pursued in only 30% of cases, a cost savings between $456,186 and $331,698 would be realized, translating to $308 to $224 per patient. Additionally, if ultrasound + xray was performed at the point of care during the first clinic visit for an injury, the definitive diagnoses could be reached on average 33.3 days earlier. In total, these results suggest a significant proportion of musculoskeletal workers comp injuries could be accurately and completely evaluated at the point of care using ultrasound and xray together. This could yield greater provider and patient confidence in the diagnosis and treatment plan as well as more expeditious accurate diagnoses leading to reductions in both direct and indirect costs. [Description provided by NIOSH]
• Subjects:
  Education Mining Occupational Health Safety Staff Development
• Keywords:
  Author Keywords: Musculoskeletal Injuries; Work Injuries; POCUS; Musculoskeletal Ultrasound MRI; Magnetic Resonance Imaging; Workers; Work Environment; Workers Compensation; Databases; Injuries; Ultrasound; X-rays; Diagnostic Techniques; Statistical Analysis; Musculoskeletal System Disorders; MSD;
• Publisher:
  University of South Florida
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Thesis
• Place as Subject:
  Florida ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-22
• NIOSHTIC Number:
  nn:20065619
• Citation:
  Tampa, FL: University of South Florida, 2019 Mar; :1-22
• Email:
  jjeffries@health.usf.edu
• Federal Fiscal Year:
  2019
• Performing Organization:
  Sunshine Education and Research Center, University of South Florida
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Speeding diagnosis and saving money using point of care ultrasound rather than MRI for work-related MSK injuries.
• End Date:
  20290630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9d623338b7def2980dedacc7c8ae7a36b123a92343d30734ce30bbef403763402bf3a3570cd100560b9dee504aa2563566953ee5eb54468e1dee8f7f893b4817
• Download URL:
  https://stacks.cdc.gov/view/cdc/249493/cdc_249493_DS1.pdf
• File Type:
  [PDF - 515.10 KB ]