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Manufacturing

NORA Manufacturing Sector Strategic Goals

927ZJHP - Analysis of Medical Cost Records from MarketScan Database

Start Date: 10/1/2009
End Date: 9/30/2010

Principal Investigator (PI)
Name: Anasua Bhattacharya
Organization: NIOSH
Sub-Unit: EID
Funded By: NIOSH

Primary Goal Addressed
None

Secondary Goal Addressed
None


Attributed to Manufacturing
50%

Project Description

Short Summary

The MarketScan Database includes comprehensive health care costs paid at the level of individual workers employed by a specified group of corporations, as well as parallel information on disability payments and workers compensation payments from a large population. The periods of eligibility are also identified. This presents an opportunity to examine whether workers with WC claims also had elevated health care utilization costs associated with the same injury or illness event that appear in the medical insurance and disability compensation systems. It also may allow investigation of whether work-related injury or illness has consequences for employment status that have cost implications.



Study Hypotheses



That health care utilization costs show a positive association with prior work-related injury or illness events, e.g., in the previous 6 months, for which a workers compensation claim was paid.

That disability costs show a positive association with a prior injury or illness event for which a workers compensation claim was paid.

That any change in employment status (e.g., full-time to part-time, partial disability or total disability/retirement) shows a positive association with a prior injury or illness event for which a workers compensation claim was paid.

That associations of workers compensation claims with higher group health costs are stronger for claims and subsequent health expenses in the same classes of illnesses (this can also be done by industry, age group and gender if there are enough observations for each illness).





Description

Background



Several studies starting from different departure points have led to the conclusion that a considerable amount of the cost of work-related injury and illness is transferred to the general health care finance system when it should be fully covered by Workers Compensation (WC). Most of the reported findings addressed specific workplaces and specific outcomes of interest, such as musculoskeletal.



The MarketScan Database includes comprehensive health care costs paid at the level of individual workers employed by a specified group of corporations, as well as parallel information on disability payments and workers compensation payments from a large population. The periods of eligibility are also identified. This presents an opportunity to examine whether workers with WC claims also had elevated health care utilization costs associated with the same injury or illness event that appear in the medical insurance and disability compensation systems. It also may allow investigation of whether work-related injury or illness has consequences for employment status that have cost implications.



Study Hypotheses



That health care utilization costs show a positive association with prior work-related injury or illness events, e.g., in the previous 6 months, for which a workers compensation claim was paid.

That disability costs show a positive association with a prior injury or illness event for which a workers compensation claim was paid.

That any change in employment status (e.g., full-time to part-time, partial disability or total disability/retirement) shows a positive association with a prior injury or illness event for which a workers compensation claim was paid.

That associations of workers compensation claims with higher group health costs are stronger for claims and subsequent health expenses in the same classes of illnesses (this can also be done by industry, age group and gender if there are enough observations for each illness).

Specific Objectives



Describe total/average group health and disability costs of individuals with and without WC claims, by industry, age group and gender.

Describe distribution of WC and STD claims by nature of injury and type of illnesses and by industry, age group and gender.

Construct analytical procedures to test various aspects of the above hypotheses that WC claims are associated with increased health care costs, disability costs and adverse changes in employment status.



The diseases and disorders that will be incorporated in this study are:

Value (MDC) Label

01 Diseases and Disorders of the Nervous System

04 Diseases and Disorders of the Respiratory System

05 Diseases and Disorders of the Circulatory System

08 Diseases and Disorders of the Musculoskeletal System and Connective Tissue

11 Diseases and Disorders of the Kidney and Urinary Tract

16 Diseases... of the Blood, Blood Forming Organs, Immunological Disorders

17 Myeloproliferative Diseases and Disorders, Poorly Differentiated Neoplasm





Methods



An extract of the major files will be taken, eliminating fields not of interest, to produce files of manageable size. A new file will be constructed that compiles for each month of medical insurance eligibility of a worker, the history of WC claims (within the 4-yr study period). Multiple regression models will be fit using not only the indicators of prior WC claims but also several other covariables such as type of coverage, age, gender, industry, type of employee, etc. Analyses will be limited to observation time when a worker had eligibility for a WC claim in the specified prior period. Average medical costs per person per year will be modeled using two-part regression models. Changes in employment status will be modeled using logistic or Poisson regression.



Objectives

Specific Objectives



Describe total/average group health and disability costs of individuals with and without WC claims, by industry, age group and gender.

Describe distribution of WC and STD claims by nature of injury and type of illnesses and by industry, age group and gender.

Construct analytical procedures to test various aspects of the above hypotheses that WC claims are associated with increased health care costs, disability costs and adverse changes in employment status.



The diseases and disorders that will be incorporated in this study are:

Value (MDC) Label

01 Diseases and Disorders of the Nervous System

04 Diseases and Disorders of the Respiratory System

05 Diseases and Disorders of the Circulatory System

08 Diseases and Disorders of the Musculoskeletal System and Connective Tissue

11 Diseases and Disorders of the Kidney and Urinary Tract

16 Diseases... of the Blood, Blood Forming Organs, Immunological Disorders

17 Myeloproliferative Diseases and Disorders, Poorly Differentiated Neoplasm







Mission Relevance

The primary mission of this project is to examine whether workers with WC claims also had elevated health care utilization costs associated with the same injury or illness event that appear in the medical insurance and disability compensation systems. The mission also involves investigation of whether work-related injury or illness has consequences for employment status that have cost implications.

All medical and indemnity costs due workplace injuries and illnesses are supposed to be covered by Workers Compensation. But in many cases part of the medical costs get shifted to group health coverages. This project tests if there is any such shifting of costs.

The MarketScan Database includes comprehensive health care costs paid at the level of individual workers employed by a specified group of corporations, as well as parallel information on disability payments and workers compensation payments from a large population. The periods of eligibility are also identified. This presents an opportunity to examine whether workers with WC claims also had elevated health care utilization costs associated with the same injury or illness event that appear in the medical insurance and disability compensation systems. It also may allow investigation of whether work-related injury or illness has consequences for employment status that have cost implications.

An extract of the major files will be taken, eliminating fields not of interest, to produce files of manageable size. A new file will be constructed that compiles for each month of medical insurance eligibility of a worker, the history of WC claims (within the 4-yr study period). Multiple regression models will be fit using not only the indicators of prior WC claims but also several other covariables such as type of coverage, age, gender, industry, type of employee, etc. Analyses will be limited to observation time when a worker had eligibility for a WC claim in the specified prior period. Average medical costs per person per year will be modeled using two-part regression models. Changes in employment status will be modeled using logistic or Poisson regression.



Page last updated: June 3, 2011
Page last reviewed: May 23, 2011
Content Source: National Institute for Occupational Safety and Health (NIOSH) Office of the Director

 

NIOSH Program:

Manufacturing