Who is paying the bills? Health care costs for musculoskeletal back disorders, Washington State union carpenters, 1989-2003.
Lipscomb-HJ; Dement-JM; Silverstein-B; Cameron-W; Glazner-JE
J Occup Environ Med 2009 Oct; 51(10):1185-1192
OBJECTIVE: Factors associated with private health insurance payment rates for musculoskeletal back disorders were examined among a 15-year cohort of union carpenters. Payment patterns were contrasted with work-related back injury rates over time. METHODS: Negative binomial regression was used to assess payment rates; generalized estimated equations accounted for multiple observations per person and cost correlation within subjects. RESULTS: Payment rates increased after work-related injury and with the number of injuries. Increasing private payments and deductibles (inflation-adjusted and discounted) were observed in contrast with a marked decline in reported work-related injuries. CONCLUSIONS: Private insurance payments do not appear to be independent of work-related back injury. Findings suggest cost-shifting from workers' compensation to the union-provided health insurance and to the worker; they also provide a warning regarding reliance on workers' compensation statistics for surveillance of work-related disorders or disease.
Back-injuries; Biomechanics; Construction; Construction-industry; Construction-workers; Demographic-characteristics; Health-care; Injuries; Mathematical-models; Musculoskeletal-system; Musculoskeletal-system-disorders; Occupational-hazards; Risk-factors; Statistical-analysis; Work-operations; Workplace-studies; Work-practices
Hester J. Lipscomb, PhD, Box 3834, Duke University Medical Center, Durham, NC 27710
Disease and Injury: Musculoskeletal Disorders of the Upper Extremities
Journal of Occupational and Environmental Medicine