OUTCOMES RESEARCH IN WASHINGTON-STATE WORKERS COMPENSATION

The extensive claim and medical bill payment databases of the Washingt on state workers' compensation system have been used to conduct epidem iologic and outcome studies of work-related conditions. Computerized a dministrative data must be supplemented with medical record review and structured interview of workers in outcome studies in order to adequa tely adjust for baseline severity and to address functional and patien t satisfaction outcomes, respectively, Three examples of surgical outc ome studies are described (carpal tunnel, lumbar fusion, thoracic outl et). Duration of disability prior to surgical intervention is an impor tant predictor of duration of disability following surgery, even when other biologic markers of severity are included in multivariate modeli ng. Sufficient follow-up time is required to adequately assess longer- term outcomes, such as return-to-work status and the substantial effec ts of residual impairment even after claim settlement. Finally, well-c onducted outcome studies may be linked to the development of surgical treatment guidelines in workers' compensation. (C) 1996 Wiley-Liss, In c.