Shuford Harry, Restrepo Tanya, Beaven Nathan, Leigh J Paul
Actuarial and Economic Services Division, National Council on Compensation Insurance, Boca Raton, FL, USA.
J Occup Environ Med. 2009 Feb;51(2):232-8. doi: 10.1097/JOM.0b013e3181954e3e.
This study provides estimates of the factors that are contributing to the escalation of medical costs.
Measures of price and utilization trends were developed to estimate their contributions to increases in workers compensation medical severity overall and across a range of services and diagnoses.
Analysis utilized medical transactions data covering approximately 327,000 closed claims for injuries occurring in 37 states in 1996, 1997, 2001, and 2002 provided to the National Council on Compensation Insurance by several large workers' compensation insurance companies.
Increases in billed medical treatments per claim contributed more than half, a shift to more costly injuries accounted for a fifth, and the increase in the average cost-per-treatment generated about a quarter of the increase in medical severity between 1996-1997 and 2001-2002.
Increases in billed medical treatments is the major cost driver in workers compensation medical costs.
本研究对导致医疗成本上升的因素进行了评估。
制定了价格和使用趋势衡量指标，以估计它们对工人赔偿医疗严重程度总体上升以及一系列服务和诊断中医疗严重程度上升的贡献。
分析使用了医疗交易数据，这些数据涵盖了1996年、1997年、2001年和2002年在37个州发生的约32.7万起已结案的工伤索赔，由几家大型工人赔偿保险公司提供给国家赔偿保险委员会。
1996 - 1997年至2001 - 2002年期间，每次索赔的计费医疗治疗增加贡献了超过一半的医疗严重程度增长，转向更昂贵的损伤占五分之一，每次治疗平均成本的增加约占医疗严重程度增长的四分之一。
计费医疗治疗的增加是工人赔偿医疗成本的主要成本驱动因素。
