成本高昂的医师对工人赔偿的影响。

The impact of cost intensive physicians on workers' compensation.

机构信息

Department of Medicine, Division of Occupational and Environmental Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287-1629, USA.

出版信息

J Occup Environ Med. 2010 Jan;52(1):22-8. doi: 10.1097/JOM.0b013e3181c91105.

DOI:10.1097/JOM.0b013e3181c91105

PMID:20042879

Abstract

OBJECTIVE

To identify physicians linked to high-cost workers' compensation claims.

METHODS

Contrast the cost and duration of claims associated with cost intensive physicians (CIPs) and other physicians (OPs) on 5 years of closed claims paid by the Louisiana Workers' Compensation Corporation.

RESULTS

Identified 77 CIPs of 2034 physicians who treated Louisiana Workers' Compensation Corporation claimants. CIPs made up 3.8% of physicians but accounted for 72% of costs. CIP's treated 16 times more claimants, and their average claim cost was four times higher than the OPs ($46,239 vs $11,390, P < 0.01). CIP claims settled in 697 versus 278 days for OPs. Adjusted for age, sex, marital status, International Classification of Diseases, 9th revision group, and initial reserve, the odds ratio of CIP claims with a final cost of >$50,000 was 5.4.

CONCLUSION

A small group of physicians (<4%) have a profound effect on overall workers' compensation costs.

摘要

目的

识别与高成本工人赔偿索赔相关联的医生。

方法

对比路易斯安那工人赔偿公司支付的 5 年封闭索赔中与高成本密集型医生（CIP）和其他医生（OP）相关的索赔的成本和持续时间。

结果

在为路易斯安那工人赔偿公司索赔人治疗的 2034 名医生中，确定了 77 名 CIP。CIP 占医生的 3.8%，但占成本的 72%。CIP 治疗的索赔人多 16 倍，其平均索赔成本是 OPs 的四倍（46239 美元比 11390 美元，P<0.01）。CIP 索赔的解决时间为 697 天，OP 为 278 天。调整年龄、性别、婚姻状况、国际疾病分类第 9 版群组和初始储备后，CIP 最终费用超过 50,000 美元的索赔的优势比为 5.4。