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At least 19 recordsLinked to original sources

Twenty-four-hour coverage and workers' compensation insurance.

Workers' compensation insurance provides cash benefits and health care for workers who are injured on the job. This DataWatch considers the costs and benefits of combining the health insurance component of workers' compensation with universal health insurance, creating a twenty-four-hour coverage plan. The paper documents a large potential savings from twenty-four-hour coverage: Workers' compensation medical charges are about twice as high as those for comparable off-work injuries. This disparity seems to result from price discrimination and lack of cost controls in workers' compensation. Twenty-four-hour coverage, however, may be difficult to implement.

Humans↗

Medical costs in workers' compensation insurance.

We examine whether patients covered by workers' compensation insurance, which covers the cost of medical care for injured workers without cost sharing and with relatively little oversight, are charged more for treatment or receive more services than patients covered by traditional insurance. Our findings indicate that workers compensation recipients are charged more for treatment. This difference persists in individual services--workers' compensation recipients are charged more per X-ray and per examination than our patients. We consider different explanations and argue that price discrimination probably plays a role.

Accidents, Occupational↗

Diagnostic and management procedures for compensable back injuries without serious associated injuries. Modeling of the 1991 injury cohort from a major Michigan compensation insurer.

STUDY DESIGN: A retrospective cohort of 2425 workers with compensated back conditions was created from the 1991 compensated cohort of the largest compensation insurer in Michigan by linking computerized information on social and demographic factors, diagnostic and management procedures, and cumulative missed worktime. OBJECTIVE: To describe medical care use from date of injury in 1991 to mid-1993 by type of back condition, to identify factors affecting this use, to determine the effect of alternative model selection strategies on identifying such factors, to investigate the timing of surgery and the use of diagnostic studies in patients with displaced or herniated discs with and without surgery, and to compare the use of medical care in the study group with that recommended by national expert panels. SUMMARY OF BACKGROUND DATA: Despite the enormous costs involved in medical care for patients with work-related back injuries, almost no information on the use of medical care is available for compensated back injuries by diagnostic and procedure code. METHODS: Use of medical care was grouped into 18 categories for tabulation. Factors affecting use of medical care were identified by logistic regression, supplemented by Cox analysis for time to first procedure. The Hosmer-Lemeshow chi-square statistic was compared with the Bayes Information Criterion for evaluating model fit. Overall model utility was evaluated by comparing receiver operating characteristic curves generated by the model. For patients with displaced or herniated discs, algorithms were used to identify the diagnostic procedures performed before and after the first surgery and the amount of time that passed before each procedure was performed. RESULTS: In patients with diagnoses of disc displacement or herniation or vertebrogenic neuritis, approximately 80% underwent radiography to obtain plain views of the spine, 75% underwent diagnostic imaging, 45% underwent electrodiagnostic procedures, and 24% underwent spinal surgery (29.3% had surgical procedures among those with disc conditions). In patients with diagnoses of back sprain or other symptomatic diagnoses, the percentages for the first three procedures are approximately 70%, 12%, and 12%, respectively. Diagnostic category, age, gender, and cumulative missed worktime predicted the receipt of diagnostic and treatment procedures. Women were 30% less likely to undergo computed axial tomography or magnetic resonance imaging and 50% less likely to undergo spinal surgery. Median time to spinal surgery was twice as long in the group that underwent diagnostic imaging and electrodiagnostic testing before surgery (134.5 days). Of the 622 patients with disc displacement/herniation, 510 (approximately 80%) had initial diagnostic imaging studies, and, of the 510, 162 (approximately 30%) had surgery. Thirteen (8%) were reoperated. Of the 162 patients who had surgery, 46 (approximately 30%) had follow-up diagnostic imaging, and, of the 46, nine (approximately 20%) were reoperated. Of the 348 managed conservatively, 96 (approximately 30%) had follow-up diagnostic imaging. CONCLUSIONS: The data suggest only modest differences in the use of medical care between this study group and noncompensated study populations from previous reports. The authors of this study estimate that 27% of diagnostic imaging studies and 43% of plain radiography of the spine could have been avoided if then available Canadian recommendations or current American, guidelines had been followed. The gender effect remains unexplained and needs to be investigated in additional studies. There was an increase of 6% in the use of surgery in compensated patients compared with the use of surgery in a recent American series involving traditional health insurance, but this may be associated with greater work disability in the compensated group. The results of the current study suggest that the use and reporting of model selection strategies and the use of receiver operati

Adolescent↗

Will Australian workers' compensation insurance management get better soon?

A study of Australian experience in the state of New South Wales (NSW) suggests that private sector underwriting of workers' compensation insurance risk plus insurer competition on premium price may put downward pressure on benefits for injured workers, inhibit rehabilitation, and cause related cost increases for taxpayers and employers. Insurer underwriting also increases workers' compensation administrative costs and means an unnecessary loss of investment income for government and industry. An emerging and better alternative for the Australian community is for government and industry to underwrite a national workers' compensation scheme and to fix premium and benefit requirements which are competitively administered by insurers. In such a regulatory environment insurer inability to compete on premium price should promote competition to provide effective services to help employers prevent injury, assist rehabilitation and contain cost. National standards are necessary to enable widespread dissemination of comparable, reliable information on the outcome of health, rehabilitation, dispute resolution and return to work services. This is required to assess the competitive performance of service providers in order to ensure effective operation of the market to achieve scheme objectives. Holistic, multi-skilled and objective rehabilitation professionals are needed who can clearly demonstrate the effectiveness of their actions in assisting injury prevention, worker rehabilitation, and safe return to work across a range of industry contexts.

Journal Article↗

Sport-related dental injury claims to the New Zealand Accident Rehabilitation & Compensation Insurance Corporation, 1993-1996: analysis of the 10 most common sports, excluding rugby union.

A large number of New Zealanders participate in sport, either formally or informally; sporting injuries are common. In New Zealand, the Accident Rehabilitation & Compensation Insurance Corporation (ACC) is the main organisation that covers sports-related dental claims. Rugby union claims are the most common. The ACC's national data from 1993 to 1996 relating to dental claims for sports injuries (excluding rugby union) were analysed. This study identified 45 other sports in which participants are also at risk for dental injuries. Total claims per sport for each year were determined, and the "top 10" sports for claims per year were identified and compared for any change over the years studied. The top 10 sports for 1993 and 1994 were, in descending order: swimming, rugby league, basketball, cricket, hockey, soccer, netball, squash, softball-baseball, and tennis. Data for 1995 and 1996 revealed a similar trend, except that touch rugby displaced tennis as the tenth-ranked sport. The most common age group for claims was the age group 10-19 years, with a male:female ratio of approximately 2:1. Many sports, in addition to rugby union, place their participants at risk of dental injury. Awareness of prevention of dental injuries should be more widely promoted for all sports.

Adolescent↗

Public and private workers' compensation insurance.

Utilizing unique data from the federal government's Social Security office, we analyze the costs of providing workers' compensation by public vs private insurers. Our analysis has the advantage that public and private recipients are likely to be more similar than public (Medicare, Medicaid) and private recipients of health insurance in the US or Canadian economies. We find that public firms appear to provide workers' compensation insurance more efficiently than private firms.

Canada↗

The influence of indemnification by workers' compensation insurance on recovery from acute backache. North Carolina Back Pain Project.

STUDY DESIGN: A prospective observational cohort was recruited from 208 randomly selected North Carolina practices. OBJECTIVE: To compare the course of compensation claimants with gainfully employed patients not so insured from the time when they first sought care for acute back pain. SUMMARY OF BACKGROUND DATA: The human and financial cost attributable to disabling chronic low back pain identified by worker's compensation programs continues to escalate. We explored the antecedents to this phenomenon. METHOD: Consecutive patients with acute low back pain were interviewed by telephone within 1 week of first seeking care and in follow-up calls after 2, 4, 8, 12, and 24 weeks to monitor functional and work status. RESULTS: Of the 1633 patients enrolled, 505 were insured by workers' compensation. These were compared with 861 who had been employed on any job for pay within 3 months of the onset of their backache but whose care was not so underwritten. Those with compensable back pain were more likely to categorize their tasks as physically demanding and had taken more time off work in the month before the baseline interview (P = 0.02). Recovery of the sense of wellness they enjoyed before this episode of back pain was delayed (Cox Model: Hazard Ratio = 0.822; P < 0.001; confidence interval: 0.733, 0.923), but recovery of function or return to work was not. This delay was independent of type of health care and perception of task demand and beyond that which could be ascribed to the quality of back pain. CONCLUSION: Each of these associations is a reproach to the fashion in which workers' compensation insurance for regional back pain serves the ethic that is its raison d'être.

Adult↗

Medical costs in workers' compensation insurance: comment.

Professors Baker and Krueger ignore some costs associated with workers' compensation. Because of these costs, the contention that physicians willfully exploit the workers' compensation system for their own gain is questioned.

Ethics, Medical↗