Koehoorn Mieke, McLeod Christopher B, Fan Jonathan, McGrail Kimberlyn M, Barer Morris L, Côté Pierre, Hogg-Johnson Sheilah
Associate Professor, School of Population and Public Health, University of British Columbia, Vancouver, BC.
Healthc Policy. 2011 Aug;7(1):55-70.
To investigate the effect of workers' compensation policies related to expedited surgical fees and private clinic surgical setting on disability duration among injured workers.
The study included 1,380 injured workers with knee meniscectomy between 2001 and 2005 in British Columbia. Using linked workers' compensation claim and surgery/clinical records, wait time for surgery (time from last surgical consult to surgery) and time from surgery to return to work were computed and compared for workers who received care in public versus private facilities, and according to whether their surgeons received fees intended to expedite care.
The public expedited group had the shortest disability duration from surgical consult to return to work; the expedited fee reduced the surgery wait time (2 work weeks), and surgeries performed in public hospitals had a shorter return-to-work time (1 work week).
An overall difference of approximately three work weeks in disability duration may have meaningful clinical and quality-of-life implications for injured workers. However, minimal differences in expedited surgical wait times by private clinics versus public hospitals, and small differences in return-to-work outcomes favouring the public hospital group, suggest that a future economic evaluation of workers' compensation policies related to surgical setting is warranted.
探讨与加急手术费用及私立诊所手术环境相关的工伤赔偿政策对受伤工人残疾持续时间的影响。
该研究纳入了2001年至2005年在不列颠哥伦比亚省接受膝关节半月板切除术的1380名受伤工人。利用工伤赔偿申请与手术/临床记录的关联，计算并比较了在公立与私立机构接受治疗的工人的手术等待时间（从上次手术会诊到手术的时间）以及从手术到恢复工作的时间，并根据其外科医生是否收取旨在加快治疗的费用进行比较。
公立加急组从手术会诊到恢复工作的残疾持续时间最短；加急费用缩短了手术等待时间（约2个工作周），且在公立医院进行的手术恢复工作时间更短（约1个工作周）。
残疾持续时间总体上约有三个工作周的差异，这可能对受伤工人具有有意义的临床和生活质量影响。然而，私立诊所与公立医院在加急手术等待时间上的差异极小，且在恢复工作结果方面有利于公立医院组的差异也很小，这表明有必要对与手术环境相关的工伤赔偿政策进行未来的经济评估。
