Koehoorn Mieke, Cole Donald C, Hertzman Clyde, Lee Hyunmi
Department of Health Care & Epidemiology, University of British Columbia, 5804 Fairview Avenue, Mather Building, Vancouver, British Columbia, Canada, V6T 1Z3.
J Occup Rehabil. 2006 Sep;16(3):411-24. doi: 10.1007/s10926-006-9022-7.
The purpose of this study was to investigate if work-related musculoskeletal disorders (WMSDs) are associated with increased health care use, over and above workers' compensation health care benefits, in the period prior to and following a workers' compensation claim indicating gradual progression and declining function associated with musculoskeletal morbidity.
This study employed secondary analysis of employment data, workers' compensation claim data and provincial (universal) medical services data for a cohort of health care workers; and investigated rates of medical care contacts among injured workers with a WMSD claim (n=549) compared to a matched group of non-claim workers. Predictors of health care contacts were estimated using general linear regression.
WMSD injured workers had significantly higher rates of health care contacts associated with a claim compared to non-injured workers, over and above workers compensation health care benefits. In the final multi-variable model, a WMSD claim among injured workers was associated with an estimated 69% (95% CI, 1.50, 1.91) increase in health care use for the 12-month period immediately after the injury date compared to non injured workers.
The pattern of visits for WMSDs suggests that workers visit general practitioners as part of an ongoing pattern of symptoms, resulting in frequent utilization of health services prior to work disability that is also reflected in health care contacts after return-to-work.
本研究的目的是调查在工伤赔偿申请之前和之后的时间段内,与工作相关的肌肉骨骼疾病(WMSD)是否与医疗保健使用增加相关,这超出了工伤赔偿医疗保健福利的范围,且表明与肌肉骨骼发病率相关的病情逐渐进展和功能下降。
本研究对一组医护人员的就业数据、工伤赔偿申请数据和省级(通用)医疗服务数据进行了二次分析;并调查了与一组匹配的未提出索赔的工人相比,有WMSD索赔的受伤工人(n = 549)的医疗接触率。使用一般线性回归估计医疗接触的预测因素。
与未受伤的工人相比,有WMSD的受伤工人与索赔相关的医疗接触率显著更高,超出了工伤赔偿医疗保健福利的范围。在最终的多变量模型中,与未受伤的工人相比,受伤工人的WMSD索赔与受伤日期后12个月期间的医疗保健使用估计增加69%(95%CI,1.50,1.91)相关。
WMSD的就诊模式表明,工人将全科医生就诊作为持续症状模式的一部分,导致在工作残疾之前频繁使用医疗服务,这也反映在重返工作岗位后的医疗接触中。