caa a22 4500 47710441X CHVBK 20180405111550.0 cr unu---uuuuu 170330e19960301xx s 000 0 eng 10.1007/BF02110391 doi (NATIONALLICENCE)springer-10.1007/BF02110391 Factors influencing the cost of chronic low back injuries: An analysis of data from independent medical examinations [Elektronische Daten] [William Earman, Gunnar Andersson, Frank Leavitt, Thomas McNeill, I. Durudogan, Joan Reagan] Cost factors were examined in 157 patients with work- related spine injuries who were referred to a second opinion program between 1985 and 1991. The independent medical examination (IME) included a history, physical examination, and review of imaging and other studies. Data on demographic variables, litigation, work, injury history, physical examination, and imaging studies were recorded. A standard measure of psychological status (Low Back Pain Symptom Check List) was filled out. The instrument uses pain language as a clinical marker of psychological disturbance linked to a range of conflictual issues such as suppressed anger, burdensome feeling of inferiority, damaged self- esteem, role confusion, abnormal mentation, fear of responsibility or intimacy, gender issues, sexual concerns, disturbing arousal, and the like. Since it relies exclusively on pain language for diagnosis, it does not identify the specific nature of the psychological conflict. Data on treatment, final resolution, and cost were obtained from computerized files of the insurance company. The total cost incurred was $6,551,139. This averaged to $41,727 per case. More expensive cases were associated with a surgical intervention, psychological disturbance, litigation, motor weakness, and positive radiographs. These five variables accounted for 48% of the cost variance. Surgery accounted for 19.9% of the variance and contained the most expensive cases ($68,310 vs. $31,423). Psychological disturbance was detected in 27% of the sample and accounted for 10.5% of the cost variance. Litigation was present in 72% of the cases and accounted for 9.1% of the cost variance. Motor strength and radiographs taken together accounted for 8.4% of the variance. The usefulness of this information was explored from an actuarial and medical perspective. Plenum Publishing Corporation, 1996 low back pain nationallicence worker compensation nationallicence back injury nationallicence second opinion nationallicence cost nationallicence psychological disturbance nationallicence litigation nationallicence Earman William Department of Orthopedics, Chicago College of Osteopathic Medicine, 60461, Olympia Fields, Illinois aut Andersson Gunnar Department of Orthopedic Surgery, Rush Medical College, 60612, Chicago, Illinois aut Leavitt Frank Department of Psychology and Social Sciences, Rush Medical College, 60612, Chicago, Illinois aut McNeill Thomas Department of Orthopedic Surgery, Rush Medical College, 60612, Chicago, Illinois aut Durudogan I. Department of Orthopedics, Chicago College of Osteopathic Medicine, 60461, Olympia Fields, Illinois aut Reagan Joan Department of Orthopedics, Chicago College of Osteopathic Medicine, 60461, Olympia Fields, Illinois aut Journal of Occupational Rehabilitation Kluwer Academic Publishers-Plenum Publishers 6/1(1996-03-01), 5-16 1053-0487 6:1<5 1996 6 10926 https://doi.org/10.1007/BF02110391 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02110391 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Earman William Department of Orthopedics, Chicago College of Osteopathic Medicine, 60461, Olympia Fields, Illinois aut NATIONALLICENCE 700 1- Andersson Gunnar Department of Orthopedic Surgery, Rush Medical College, 60612, Chicago, Illinois aut NATIONALLICENCE 700 1- Leavitt Frank Department of Psychology and Social Sciences, Rush Medical College, 60612, Chicago, Illinois aut NATIONALLICENCE 700 1- McNeill Thomas Department of Orthopedic Surgery, Rush Medical College, 60612, Chicago, Illinois aut NATIONALLICENCE 700 1- Durudogan I. Department of Orthopedics, Chicago College of Osteopathic Medicine, 60461, Olympia Fields, Illinois aut NATIONALLICENCE 700 1- Reagan Joan Department of Orthopedics, Chicago College of Osteopathic Medicine, 60461, Olympia Fields, Illinois aut NATIONALLICENCE 773 0- Journal of Occupational Rehabilitation Kluwer Academic Publishers-Plenum Publishers 6/1(1996-03-01), 5-16 1053-0487 6:1<5 1996 6 10926 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer