Chibnall John T, Tait Raymond C, Andresen Elena M, Hadler Nortin M
Department of Psychiatry, Saint Louis University School of Medicine, St. Louis, MO 63104, USA.
Spine (Phila Pa 1976). 2006 May 15;31(11):1272-5. doi: 10.1097/01.brs.0000217584.79528.9b.
Population-based telephone survey in Missouri.
To examine the unique contribution of race to diagnosis and surgery rates in workers' compensation claimants.
Race differences in diagnostic specificity and rates of surgery may mediate documented differences in workers' compensation case management outcomes (treatment expenditures, disability ratings, and settlement awards) between African Americans and whites with low back injuries.
African American (n = 580) and white (n = 892) workers' compensation claimants with single-incident low back injuries were interviewed regarding diagnoses and treatments received for their injury. Participants were, on average, 21 months after settlement. Analyses examined the association of race (controlling for clinical findings, legal representation, age, gender, and socioeconomic status) with diagnosis (herniated disc vs. regional backache) and surgery. Risk ratios for race were calculated.
Whites were 40% more likely than African Americans to receive a herniated disc diagnosis. Of claimants with the latter diagnosis, whites were 110% more likely than African Americans to undergo surgery.
Race differences in diagnosis and surgery may help to explain why African Americans, relative to whites, receive lower workers' compensation medical expenditures, disability ratings, and settlement awards.
在密苏里州进行的基于人群的电话调查。
探讨种族因素对工伤赔偿申请人诊断率和手术率的独特影响。
诊断特异性和手术率方面的种族差异可能是造成非洲裔美国人和白人因腰伤而获得的工伤赔偿案件管理结果（治疗费用、残疾评级和理赔金额）存在差异的原因。
对580名非洲裔美国人和892名白人工伤赔偿申请人进行了访谈，这些申请人均因单次事故导致腰伤，访谈内容涉及他们所接受的损伤诊断和治疗情况。参与者平均在理赔后21个月接受访谈。分析研究了种族因素（控制临床症状、法律代理、年龄、性别和社会经济地位）与诊断（椎间盘突出症与局部背痛）及手术之间的关联，并计算了种族风险比。
白人被诊断为椎间盘突出症的可能性比非洲裔美国人高40%。在被诊断为椎间盘突出症的申请人中，白人接受手术的可能性比非洲裔美国人高110%。
诊断和手术方面的种族差异可能有助于解释为何非洲裔美国人相对于白人获得的工伤赔偿医疗费用、残疾评级和理赔金额较低。
