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Movva N, Pastula ST, Rege SV, Lewis RJ, Bylsma LC. Scoping Review of Employer-Led Research Using Employee Health Claims Data. Popul Health Manag 2023; 26:341-352. [PMID: 37682577 PMCID: PMC10611962 DOI: 10.1089/pop.2023.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
Employers may evaluate employee claims data for various reasons, including assessment of medical insurance and wellness plan efficacy, monitoring employee health trends, and identifying focus areas for wellness measures. The objective of this scoping review (ScR) is to describe the available literature reporting the use, applications, and outcomes of employee health claims data by self-insured employers. The ScR was conducted in a stepwise manner using an established framework: identifying the research question, identifying and selecting relevant studies, charting the data, and collating and reporting results. Literature searches were conducted in PubMed and Embase. Studies of self-insured employee populations that were conducted by the employer/s through May 2022 were identified using predefined criteria. Forty-one studies were included. The majority (90%) were cohort study designs; most employers (51%) were in industries such as aluminum production and health insurance providers. Twenty-four (59%) studies supplemented claims data with other sources such as human resource data to evaluate programs and/or health outcomes. A range of exposures (eg, chronic conditions, wellness program participation) and outcomes (eg, rates or costs of conditions, program effectiveness) were considered. Among the 25 studies that reported on patient confidentiality and privacy, 68% indicated institutional review board approval and 48% reported use of deidentified data. Many self-insured employers have used employee health claims data to gain insights into their employees' needs and health care utilization. These data can be used to identify potential improvements for wellness and other targeted programs to improve employee health and decrease absenteeism.
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Affiliation(s)
- Naimisha Movva
- EpidStrategies, A Division of ToxStrategies, Rockville, Maryland, USA
| | - Susan T. Pastula
- EpidStrategies, A Division of ToxStrategies, Rockville, Maryland, USA
| | - Saumitra V. Rege
- ExxonMobil Biomedical Sciences, Inc. (EMBSI), Annandale, New Jersey, USA
| | - R. Jeffrey Lewis
- Epidemiology Contractor (Retired EMBSI), Lavallette, New Jersey, USA
| | - Lauren C. Bylsma
- EpidStrategies, A Division of ToxStrategies, Rockville, Maryland, USA
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McClure ES, Vasudevan P, DeBono N, Robinson WR, Marshall SW, Richardson D. Cancer and noncancer mortality among aluminum smelting workers in Badin, North Carolina. Am J Ind Med 2020; 63:755-765. [PMID: 32649003 PMCID: PMC7890681 DOI: 10.1002/ajim.23150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Badin, North Carolina, hosted an aluminum smelting plant from 1917 to 2007. The Concerned Citizens of West Badin reported suspected excess cancer mortality among former employees. This study aimed to investigate these concerns. METHODS The study cohort was enumerated from United Steel Workers' records of workers employed from 1980 to 2007. Cause-specific mortality rates in the cohort were compared with North Carolina population mortality rates using standardized mortality ratios (SMRs), standardized by age, sex, race, and calendar period. We estimated cause-specific adjusted standardized mortality ratios (aSMRs) using negative controls to mitigate healthy worker survivor bias (HWSB). Standardized rate ratios (SRRs) were calculated to compare mortality rates between workers ever employed vs never employed in the pot room. RESULTS All-cause mortality among Badin workers was lower than in the general population (SMR: 0.81, 95% confidence interval [CI]: 0.71-0.92). After adjusting for HWSB, excesses for all cancers (aSMR: 1.55, 95% CI: 1.10-2.21), bladder cancer (3.47, 95% CI: 1.25-9.62), mesothelioma (17.33, 95% CI: 5.40-55.59), and respiratory cancer (1.24, 95% CI: 0.77-1.99) were observed. Black males worked the highest proportion of their employed years in the pot room. Potroom workers experienced higher respiratory cancer (SRR: 2.99, 95% CI: 1.23-7.26), bladder cancer (SRR: 1.58, 95% CI: 0.15-15.28), and mesothelioma (SRR: 3.36, 95% CI: 0.21-53.78) mortality rates than never workers in the pot room. CONCLUSIONS This study responds to concerns of a group of former aluminum workers. The results, while imprecise, suggest excess respiratory and bladder cancers among pot room workers in a contemporary cohort of union employees at a US smelter.
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Affiliation(s)
- Elizabeth S McClure
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Pavithra Vasudevan
- Department of African and African Diaspora Studies/Center for Women’s and Gender Studies, University of Texas, Austin, TX
| | - Nathan DeBono
- Occupational Cancer Research Centre, Toronto, Ontario
| | - Whitney R Robinson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Stephen W. Marshall
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - David Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Elser H, Neophytou AM, Tribett E, Galusha D, Modrek S, Noth EM, Meausoone V, Eisen EA, Cantley LF, Cullen MR. Cohort Profile: The American Manufacturing Cohort (AMC) study. Int J Epidemiol 2020; 48:1412-1422j. [PMID: 31220278 DOI: 10.1093/ije/dyz059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Holly Elser
- Division of Epidemiology, UC Berkeley School of Public Health, Berkeley, CA, USA.,Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Andreas M Neophytou
- Division of Environmental Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA.,Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Erika Tribett
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Deron Galusha
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Sepideh Modrek
- Department of Economics, San Francisco State University, College of Business, San Francisco, CA, USA
| | - Elizabeth M Noth
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Valerie Meausoone
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Ellen A Eisen
- Division of Environmental Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA
| | - Linda F Cantley
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Mark R Cullen
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
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Hou B. The medium and long-term effect of electrophysiologic monitoring on the facial nerve function in minimally invasive surgery treating acoustic neuroma. Exp Ther Med 2018; 15:2347-2350. [PMID: 29563978 PMCID: PMC5854939 DOI: 10.3892/etm.2018.5683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 12/13/2017] [Indexed: 11/05/2022] Open
Abstract
The medium and long-term effects of electrophysiologic monitoring on the facial nerve function in minimally invasive surgery treating acoustic neuroma were studied. Sixty-two patients with acoustic neuroma taking minimally invasive surgeries in Dezhou Hospital from August 2014 to September 2015 were selected and randomly divided into 29 cases of the control group and 33 cases of the observation group. Intraoperative electrophysiologic monitoring was applied to the observation group, but not to the control group. The effects of the surgeries were compared. Comparisons on the surgical resection rate and the surgery length between two groups showed no statistical differences (P>0.05); the anatomical and functional preservation rate of facial nerves, as well as the score of survival quality in the observation group prominently proceeded that in the control group, and the differences were statistically significant (P>0.05). In conclusion, the application of the electrophysiologic monitoring on facial nerve function in minimally invasive surgery treating acoustic neuroma can effectively increase the anatomical and functional preservation rate of facial nerves, providing certain clinical significance to the improvement of living quality.
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Affiliation(s)
- Baohui Hou
- Department of Neurosurgery, Dezhou Municipal Hospital, Dezhou, Shandong 253012, P.R. China
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Kurtcan S, Alkan A, Kilicarslan R, Bakan AA, Toprak H, Aralasmak A, Aksoy F, Kocer A. Auditory Pathway Features Determined by DTI in Subjects with Unilateral Acoustic Neuroma. Clin Neuroradiol 2015; 26:439-444. [PMID: 25813527 DOI: 10.1007/s00062-015-0385-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/04/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE In the studies concerning the pathology of the auditory pathway in the vestibulocochlear system, few use advanced neuroimaging applications of magnetic resonance imaging (MRI) such as diffusion tensor imaging (DTI). Those who did use reported DTI changes only at the lateral lemniscus and inferior colliculus level. The aim of our study was to determine diffusion changes in the bilateral auditory pathways of subjects with unilateral acoustic neuroma (AN) and compare them with healthy controls. MATERIAL AND METHODS A total of 15 subjects with unilateral AN along with 11 controls underwent routine MRI and DTI. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values obtained from the lateral lemniscus, inferior colliculus, corpus geniculatum mediale, and Heschl's gyrus of the auditory pathway were then compared. RESULTS The subjects' ADC values measured from the contralateral side were significantly higher at the lateral lemniscus, inferior colliculus, and corpus geniculatum mediale compared with those of the controls. Also, decreased FA values were noted at the inferior colliculus for both the contralateral and ipsilateral sides. The highest ADC values were detected in the inferior colliculus of the auditory pathway. CONCLUSIONS In the auditory pathway of subjects with AN, the contralateral side is more affected than the ipsilateral side, the most affected region being the inferior colliculus. DTI is an advanced neuroimaging technique that can be used to determine the presence of microstructural damage to the auditory pathway in subjects with AN, whereas conventional MRI is not sensitive enough to detect damage.
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Affiliation(s)
- S Kurtcan
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, 34093, Istanbul, Turkey.
| | - A Alkan
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, 34093, Istanbul, Turkey
| | - R Kilicarslan
- Department of Radiology, Faculty of Medicine, Medipol University, Istanbul, Turkey
| | - A A Bakan
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, 34093, Istanbul, Turkey
| | - H Toprak
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, 34093, Istanbul, Turkey
| | - A Aralasmak
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, 34093, Istanbul, Turkey
| | - F Aksoy
- Department of Otorhinolaryngology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - A Kocer
- Department of Neurology, Faculty of Medicine, Medeniyet University, Istanbul, Turkey
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