Fayad Rim, Nuwayhid Iman, Tamim Hala, Kassak Kassem, Khogali Mustafa
Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Bull World Health Organ. 2003;81(7):509-16. Epub 2003 Sep 3.
To estimate the medical and compensation costs of work-related injuries in insured workplaces in Lebanon and to examine cost distributions by worker and injury characteristics.
A total of 3748 claims for work injuries processed in 1998 by five major insurance companies in Lebanon were reviewed. Medical costs (related to emergency room fees, physician consultations, tests, and medications) and wage and indemnity compensation costs were identified from the claims.
The median cost per injury was US dollars 83 (mean, US dollars 198; range, US dollars 0-16,401). The overall cost for all 3748 injuries was US dollars 742,100 (76% of this was medical costs). Extrapolated to all injuries within insured workplaces, the overall cost was US dollars 4.5 million a year; this increased to US dollars 10 million-13 million when human value cost (pain and suffering) was accounted for. Fatal injuries (three, 0.1%) and those that caused permanent disabilities (nine, 0.2%) accounted for 10.4% of the overall costs and hospitalized injuries (245, 6.5%) for 45%. Cost per injury was highest among older workers and for injuries that involved falls and vehicle incidents. Medical, but not compensation, costs were higher among female workers.
The computed costs of work injuries--a fraction of the real burden of occupational injuries in Lebanon--represent a considerable economic loss. This calls for a national policy to prevent work injuries, with a focus on preventing the most serious injuries. Options for intervention and research are discussed.
估算黎巴嫩参保工作场所与工伤相关的医疗和赔偿费用,并按工人及工伤特征研究费用分布情况。
回顾了黎巴嫩五家主要保险公司在1998年处理的3748起工伤索赔案件。从索赔案件中确定了医疗费用(与急诊室费用、医生诊疗、检查及药物相关)以及工资和赔偿费用。
每起工伤的中位数费用为83美元(平均数为198美元;范围为0 - 16401美元)。3748起工伤的总费用为742,100美元(其中76%为医疗费用)。推算至参保工作场所内的所有工伤,每年的总费用为450万美元;若计入人力价值成本(痛苦与折磨),则增至1000万 - 1300万美元。致命工伤(3起,0.1%)和导致永久性残疾的工伤(9起,0.2%)占总费用的10.4%,住院工伤(245起,6.5%)占45%。工伤费用在年长工人以及涉及跌倒和车辆事故的工伤中最高。女性工人的医疗费用较高,但赔偿费用并非如此。
计算得出的工伤费用——仅占黎巴嫩职业伤害实际负担的一部分——代表了相当大的经济损失。这需要制定一项预防工伤的国家政策,重点是预防最严重的工伤。文中讨论了干预和研究的选项。