scholarly journals Exploring ‘Return to Productivity’ Among People Living with Burn Injury: a Burn Model System National Database Report

2021 ◽  
Author(s):  
Clifford C Sheckter ◽  
Sabina Brych ◽  
Gretchen J Carrougher ◽  
Steven E Wolf ◽  
Jeffrey C Schneider ◽  
...  
Keyword(s):  
Return To Work ◽  
Burn Injury ◽  
Model System ◽  
National Database ◽  
Post Injury ◽  
Explanatory Variables ◽  
Patients At Risk ◽  
Income Data ◽  
Gain Loss

Abstract Introduction Burn survivors experience barriers to returning to work. For those who do return to work, little is known regarding whether they achieve pre-injury productivity (i.e., equivalent or gain in income compared to pre-injury income). Identifying patients at risk of not achieving pre-injury productivity is important for targeting services that support this population. Methods We extracted occupational and income data through 24 months post-injury from the multi-center, longitudinal Burn Model System National Database. Annual income was reported in six groups: <$25k, $25k-50k, $50k-99k, $100k-149k, $150k-199k, $>199k. Participants were classified by change in income at each follow up (i.e., gain, loss, equivalent). Explanatory variables included demographics, injury characteristics, insurance payer, employment status, and job type. Multi-level, multi-variable logistic regression was used to model return to productivity. Results 453 participants provided complete income data at discharge and follow up. Of the 302 participants employed pre-injury, 180 (60%) returned to work within 24 months post-injury. Less than half (138) returned to productivity (46% of participants employed pre-injury; 77% of those who returned to work). Characteristics associated with return to productivity included older age (median 46.9 vs 45.9 years, OR 1.03, p=0.006), Hispanic ethnicity (24% vs 11%, OR 1.80, p=0.041), burn size >20% TBSA (33.7% vs 33.0%, OR 2.09, p=0.045), and post-injury employment (54% vs 26%, OR 3.41, p<0.001). Conclusion More than half of employed people living with burn injury experienced loss in productivity within 24 months post-injury. Even if they return to work, people living with burn injuries face challenges returning to productivity and may benefit from vocational rehabilitation and/or financial assistance.

5 Examining ‘Return to Productivity’ Among People Living with Burn Injury: A Burn Model System National Database Report

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S9-S10
Author(s):  
Clifford C Sheckter ◽  
Gretchen J Carrougher ◽  
Mallory B Smith ◽  
Steven E Wolf ◽  
Jeffrey C Schneider ◽  
...  
Keyword(s):  
Burn Injury ◽  
Private Insurance ◽  
Model System ◽  
National Database ◽  
Post Injury ◽  
Explanatory Variables ◽  
Job Type ◽  
Burn Survivors ◽  
Gain Loss

Abstract Introduction Burn injuries can be life-altering events that involve intensive healthcare, changes in body image, psychological stress and financial toxicity. Burn survivors frequently experience numerous and varied barriers to returning to work. For those who return to work, little is known regarding whether they achieve pre-injury productivity (i.e., equivalent work output and/or pay). Understanding return to productivity and patients at risk of not achieving pre-injury productivity is important for targeting services that support this population and their families. Methods Burn survivors with complete occupational and personal income data through 24 months post-injury were extracted from the NIDILRR Burn Model System National Database. Participant annual income was reported in six groups: < $25k, $25k-50k, $50k-99k, $100k-149k, $150k-199k, $ >199k. Participants were classified by their change in income at each follow up (i.e., gain, loss, equivalent). Explanatory variables of interest included demographics, payer, job type, and injury characteristics. Logistic regression modeled return to productivity (i.e., equivalent or gain in income compared to pre-injury status) at each follow up interval. Results Data from 402 participants were analyzed. At 6-, 12-, and 24-months post-injury, 77%, 79%, and 71% of participants reported equivalent or gain in income, respectively. Physical and labor-based jobs were reported by 60% of participants who had return to productivity versus 63% of those who lost income. Demographics, payer, and job type were not significantly associated with differences in return to productivity. Mean %TBSA burn size was 17.4% in those who returned to productivity versus 26.1% among those who did not. Burn size ≥50% TBSA was the only predictor of decreased likelihood for return to productivity (OR 0.24, 95%CI 0.06–0.90). Post hoc comparison to participants who did not have complete financial data demonstrated that participants with complete data were significantly more likely to be older, white, have smaller burns, and carry private insurance. Conclusions Most burn survivors returned to pre-injury productivity by 24-months after injury regardless of demographics, job type, and payer status. Burn survivors who experienced ≥50% TBSA burns were much more likely to not return to pre-injury productivity.

Impact of Burn-Related Amputations on Return to Work: Findings From the Burn Injury Model System National Database

2018 ◽  
Vol 40 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Gretchen J Carrougher ◽  
Kara McMullen ◽  
Samuel P Mandell ◽  
Dagmar Amtmann ◽  
Karen J Kowalske ◽  
...  
Keyword(s):  
Return To Work ◽  
Burn Injury ◽  
Model System ◽  
National Database ◽  
Injury Model

The impact of discharge contracture on return to work after burn injury: A Burn Model System investigation

Burns ◽  
2020 ◽  
Vol 46 (3) ◽  
pp. 539-545
Author(s):  
Tam N. Pham ◽  
Richard Goldstein ◽  
Gretchen J. Carrougher ◽  
Nicole S. Gibran ◽  
Jeremy Goverman ◽  
...  
Keyword(s):  
Return To Work ◽  
Burn Injury ◽  
Model System ◽  
The Impact

An Examination of Follow-up Services Received by Vulnerable Burn Populations: A Burn Model System National Database Study

2019 ◽  
Vol 41 (2) ◽  
pp. 377-383
Author(s):  
Lynne Benavides ◽  
Vivian Shie ◽  
Brennan Yee ◽  
Miranda Yelvington ◽  
Laura C Simko ◽  
...  
Keyword(s):  
Vulnerable Populations ◽  
Long Term Care ◽  
Model System ◽  
Psychological Therapy ◽  
Psychological Services ◽  
National Database ◽  
Vulnerable Group ◽  
Term Care

Abstract While disparities in healthcare outcomes and services for vulnerable populations have been documented, the extent to which vulnerable burn populations demonstrate disparities in long-term care is relatively underexplored. This study’s goal was to assess for differences in long-term occupational or physical therapy (OT/PT) and psychological service use after burn injury in vulnerable populations. Data from the Burn Model System National Database (2006–2015) were analyzed. The vulnerable group included participants in one or more of these categories: 65 years of age or older, nonwhite, no insurance or Medicaid insurance, preinjury receipt of psychological therapy or counseling, preinjury alcohol and/or drug misuse, or with a preexisting disability. Primary outcomes investigated were receipt of OT/PT and psychological services. Secondary outcomes included nine OT/PT subcategories. Outcomes were examined at 6, 12, and 24 months postinjury. One thousand one hundred thirty-six burn survivors (692 vulnerable; 444 nonvulnerable) were included. The vulnerable group was mostly female, unemployed at time of injury, and with smaller burns. Both groups received similar OT/PT and psychological services at all time points. Adjusted regression analyses found that while the groups received similar amounts services, some vulnerable subgroups received significantly more services. Participants 65 years of age or older, who received psychological therapy or counseling prior to injury, and with a preexisting disability received more OT/PT and psychological or peer support services at follow-up. Overall, vulnerable and nonvulnerable groups received comparable OT/PT and psychological services. The importance of long-term care among vulnerable subgroups of the burn population is highlighted by this study. Future work is needed to determine adequate levels of follow-up services.

576 Firefighter Post-injury Return to Work: A Balance of Dedication and Obligation

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S130-S130
Author(s):  
Lauren B Nosanov ◽  
Kathleen S Romanowski
Keyword(s):  
Return To Work ◽  
Burn Injury ◽  
Organizational Level ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Post Injury ◽  
Cross Sectional ◽  
Burn Center ◽  
Medical Evaluation ◽  
The Individual

Abstract Introduction Over the duration of firefighters’ careers there exists a high probability of sustaining burn injuries necessitating medical evaluation and treatment. While many are minor and do not significantly affect the ability to work in full capacity, there exists risk for both short and long-term incapacitation. It is not uncommon for firefighters to push for earlier return to work than is medically advisable. However, there are additional external factors which drive premature return to duty. Methods An online cross-sectional survey was sent to firefighters who were members of a statewide Professional Firefighters’ Union. A multiple-choice format was used to assess demographics, injury details, medical care received and return to work. Free text format allowed for elaboration regarding factors influencing decisions to return to work. Results The survey was sent to 30,000 firefighters, with 413 (1.4%) responses received. Excluding those with incomplete data, 354 remained for analysis. Of these, 132 (37.3%) reported a burn injury which required medical evaluation. The majority were sustained during active duty, with 90.7% using protective gear at the time. Most burns were small and affected the head (50.8%) and upper extremities (48.3%). The majority were not treated at a Burn Center. While 12 (16.2%) reported returning to work prematurely themselves, nearly half indicated that they knew a colleague whom they felt had returned to work too soon. Factors cited include firefighter culture, finances, limitations of workman’s compensation, pressure from peers and employers, dislike of light duty and a driving desire to get back to work. Conclusions While many cite love of the job and a culture of pride and camaraderie that is “in our DNA”, firefighters’ decisions to return to work after burn injury are equally driven external pressures and obligations. Additional education is needed at both the individual and organizational level, which may best be facilitated by evaluation and treatment at a Burn Center. Applicability of Research to Practice Improved understanding of factors driving firefighters’ views on returning to duty after injury may help establish support systems and improve education regarding risks of premature return to work, particularly with regard to reinjury.

24 Factors Affecting Return to Work: A Burn Model System National Database Investigation

2018 ◽  
Vol 39 (suppl_1) ◽  
pp. S17-S17
Author(s):  
G J Carrougher ◽  
S P Mandell ◽  
S B Brych ◽  
J C Schneider ◽  
C M Ryan ◽  
...  
Keyword(s):  
Return To Work ◽  
Model System ◽  
National Database ◽  
Factors Affecting

Factors Affecting Employment After Burn Injury in the United States: A Burn Model System National Database Investigation

2020 ◽  
Vol 101 (1) ◽  
pp. S71-S85 ◽  
Author(s):  
Gretchen J. Carrougher ◽  
Alyssa M. Bamer ◽  
Samuel P. Mandell ◽  
Sabina Brych ◽  
Jeffrey C. Schneider ◽  
...  
Keyword(s):  
United States ◽  
Burn Injury ◽  
The United States ◽  
Model System ◽  
National Database ◽  
Factors Affecting

572 Examination of Gender Differences in Return to School and PROMIS-25® Outcomes for Pediatric Burn Survivors

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S127-S128
Author(s):  
Olivia Stockly ◽  
Audrey E Wolfe ◽  
Nicole S Gibran ◽  
Colleen M Ryan ◽  
Jeffrey C Schneider
Keyword(s):  
Gender Differences ◽  
Health Outcomes ◽  
Clinical Characteristics ◽  
Burn Injury ◽  
National Database ◽  
Post Injury ◽  
Burn Survivors ◽  
School Status ◽  
The Impact

Abstract Introduction Gender differences in pediatric burn outcomes are not well-known. Long-term physical and mental health outcomes, in addition to school status, serve as important markers in recovery for school-aged burn survivors. This study aimed to assess the impact of gender on school status and health outcomes in pediatric burn survivors. Methods Data from pediatric burn survivors, age 8–17 years at time of injury that are participating in the Burn Model System National Database (2015–2019) were analyzed. Descriptive statistics were generated for demographic and clinical characteristics. Scores on the seven subscales of the PROMIS-25 (physical function, anxiety, depression, fatigue, peer support, pain interference, and pain intensity) and school status at 12 months post-injury were examined. All demographic, clinical, and outcome data were compared by gender using Chi-square tests of association and two-sample t-tests for categorical and continuous variables, respectively. Results A total of 104 individuals (76 male, 28 female) were included in the demographic analysis. Additionally, 60 individuals had complete PROMIS-25® data at 12 months post-injury and were included in analysis. Demographic and clinical characteristics including age at time of burn injury, race/ethnicity, burn etiology, burn location and burn size did not differ by gender. No differences were found in PROMIS-25® subscales (p=0.22–0.87; Table 1) or school status by gender. Nearly 80% of male and female burn survivors were in school at 12-months post-injury (76.6% male vs. 88.2% female; p=0.307). Conclusions In this study, burn survivors between the ages of 8 and 17 years old did not experience any differences in long-term PROMIS-25® outcomes or school status at 12 months post-injury based on gender. Applicability of Research to Practice Preliminary data suggest similar physical, mental, and school outcomes for school aged children based on gender. A more robust examination of long-term pediatric outcomes and school status are needed in the future.

Trends 10 years after burn injury: A Burn Model System National Database study

Burns ◽  
2018 ◽  
Vol 44 (8) ◽  
pp. 1882-1886 ◽  
Author(s):  
Theresa L. Chin ◽  
Gretchen J. Carrougher ◽  
Dagmar Amtmann ◽  
Kara McMullen ◽  
David N. Herndon ◽  
...  
Keyword(s):  
Burn Injury ◽  
Model System ◽  
National Database ◽  
Database Study

Temperature sensitivity after burn injury: A Burn Model System National Database Hot Topic

2021 ◽  
Author(s):  
Jamie Oh ◽  
Christopher Madison ◽  
Grace Flott ◽  
Elisha G Brownson ◽  
Stephen Sibbett ◽  
...  
Keyword(s):  
Temperature Sensitivity ◽  
Satisfaction With Life ◽  
Burn Injury ◽  
Model System ◽  
Satisfaction With Life Scale ◽  
National Database ◽  
Linear Regression Models ◽  
Chi Square ◽  
Related Quality ◽  
Over Time

Abstract Background People living with burn injury often report temperature sensitivity. However, its epidemiology and associations with health-related quality of life (HRQOL) are unknown. We aimed to characterize temperature sensitivity and determine its impact on HRQOL to inform patient education after recovery from burn injury. Methods We used the multicenter, longitudinal Burn Model System National Database to assess temperature sensitivity at 6, 12 and 24 months after burn injury. Chi-square and Kruskal-Wallis tests determined differences in patient and injury characteristics. Multivariable, multi-level generalized linear regression models determined the association of temperature sensitivity with Satisfaction with Life Scale (SWL) scores and Veterans RAND 12 (VR-12) physical (PCS) and mental health summary (MCS) component scores. Results The cohort comprised 637 participants. Two thirds (66%) experienced temperature sensitivity. They had larger burns (12% TBSA, IQR 4-30 vs 5% TBSA, IQR 2-15; p<0.0001), required more grafting (5% TBSA, IQR 1-19 vs 2% TBSA, IQR 0-6; p<0.0001), and had higher intensity of pruritus at discharge (11% severe vs 5% severe; p=0.002). After adjusting for confounding variables, temperature sensitivity was strongly associated with lower SWL (OR -3.2, 95% CI -5.2, -1.1) and MCS (OR -4.0, 95% CI -6.9, -1.2) at 6-months. Temperature sensitivity decreased over time (43% at discharge, 4% at 24-months) and was not associated with poorer HRQOL at 12 and 24 months. Conclusion Temperature sensitivity is common after burn injury and associated with worse SWL and MCS during the first year after injury. However, temperature sensitivity seems to improve and be less intrusive over time.

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