Kucera Kristen L, Lipscomb Hester J, Silverstein Barbara
Division of Occupational & Environmental Medicine, Duke University, 2200 W.Main St., Durham, NC 27705, USA.
Work. 2011;39(3):321-30. doi: 10.3233/WOR-2011-1180.
We describe medical care received through workers' compensation (WC) and union-provided insurance surrounding work-related back injuries and examine relationships between care provided and time off work among a large cohort of carpenters.
Union records identified a cohort of 20,642 carpenters working in Washington State from 1989-2003 and their private health insurance claims. These data were linked to workers' compensation files from this state-run program including records of medical care.
Over 74,000 WC medical encounters resulted from 2959 work-related back injuries. Eleven percent received private care for musculoskeletal back pain within 90 days of work-related injury; this proportion increased with increasing lost days. Delay to physical therapy was more prevalent among those out of work longest. The proportion of claimants with care from both systems and from private utilization only increased after the first 90 days and, for the subset with at least one paid lost work day, after return to work.
Examination of medical care through both systems versus solely in workers' compensation provides a more complete understanding of back injury care while also demonstrating complexity. Differences in outcomes based upon treatment shortly after injury are worthy of further exploration.
我们描述了通过工伤赔偿（WC）和工会提供的保险所获得的围绕工作相关背部损伤的医疗护理，并研究了一大批木匠所接受的护理与误工时间之间的关系。
工会记录确定了1989年至2003年在华盛顿州工作的20642名木匠队列及其私人医疗保险索赔。这些数据与该州运营项目的工伤赔偿档案相关联，包括医疗护理记录。
2959例工作相关背部损伤导致超过74000次WC医疗就诊。11%的人在工伤后90天内接受了针对肌肉骨骼背部疼痛的私人护理；这一比例随着误工天数的增加而上升。物理治疗延迟在失业时间最长的人群中更为普遍。同时接受两种系统护理和仅接受私人护理的索赔者比例在最初90天后增加，对于至少有一个带薪误工日的子集，在重返工作岗位后增加。
通过两种系统而非仅在工伤赔偿范围内检查医疗护理，能更全面地了解背部损伤护理情况，同时也显示出其复杂性。受伤后不久基于治疗的结果差异值得进一步探索。
