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移民和美国出生工人的非致命性职业伤害相关的医疗支出。

Medical expenditures associated with nonfatal occupational injuries among immigrant and U.S.-born workers.

机构信息

Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, College of Medicine, The Ohio State University, 700 Children's Drive, Columbus, OH 43205, USA.

出版信息

BMC Public Health. 2012 Aug 20;12:678. doi: 10.1186/1471-2458-12-678.

DOI:10.1186/1471-2458-12-678
PMID:22905938
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3490770/
Abstract

BACKGROUND

No national study has investigated whether immigrant workers are less likely than U.S.-workers to seek medical treatment after occupational injuries and whether the payment source differs between two groups.

METHODS

Using the 2004-2009 Medical Expenditure Panel Survey (MEPS) data, we estimated the annual incidence rate of nonfatal occupational injuries per 100 workers. Logistic regression models were fitted to test whether injured immigrant workers were less likely than U.S.-born workers to seek professional medical treatment after occupational injuries. We also estimated the average mean medical expenditures per injured worker during the 2 year MEPS reference period using linear regression analysis, adjusting for gender, age, race, marital status, education, poverty level, and insurance. Types of service and sources of payment were compared between U.S.-born and immigrant workers.

RESULTS

A total of 1,909 injured U.S.-born workers reported 2,176 occupational injury events and 508 injured immigrant workers reported 560 occupational injury events. The annual nonfatal incidence rate per 100 workers was 4.0% (95% CI: 3.8%-4.3%) for U.S.-born workers and 3.0% (95% CI: 2.6%-3.3%) for immigrant workers. Medical treatment was sought after 77.3% (95% CI: 75.1%-79.4%) of the occupational injuries suffered by U.S.-born workers and 75.6% (95% CI: 69.8%-80.7%) of the occupational injuries suffered by immigrant workers. The average medical expenditure per injured worker in the 2 year MEPS reference period was $2357 for the U.S.-born workers and $2,351 for immigrant workers (in 2009 U.S. dollars, P = 0.99). Workers' compensation paid 57.0% (95% CI: 49.4%-63.6%) of the total expenditures for U.S.-born workers and 43.2% (95% CI: 33.0%-53.7%) for immigrant workers. U.S.-born workers paid 6.7% (95% CI: 5.5%-8.3%) and immigrant workers paid 7.1% (95% CI: 5.2%-9.6%) out-of-pocket.

CONCLUSIONS

Immigrant workers had a statistically significant lower incidence rate of nonfatal occupational injuries than U.S.-born workers. There was no significant difference in seeking medical treatment and in the mean expenditures per injured worker between the two groups. The proportion of total expenditures paid by workers' compensation was smaller (marginally significant) for immigrant workers than for U.S.-born workers.

摘要

背景

尚无研究调查移民工人在职业伤害后接受治疗的可能性是否低于美国工人,以及两组人群的支付来源是否存在差异。

方法

利用 2004-2009 年医疗支出面板调查(MEPS)数据,我们估计了每 100 名工人中非致命性职业伤害的年发生率。使用 logistic 回归模型检验受伤的移民工人在职业伤害后是否比美国出生的工人更不可能寻求专业医疗治疗。我们还使用线性回归分析估计了在 MEPS 参考期内每 1 名受伤工人的平均医疗支出,调整了性别、年龄、种族、婚姻状况、教育程度、贫困水平和保险等因素。比较了美国出生工人和移民工人之间的服务类型和支付来源。

结果

共有 1909 名受伤的美国出生工人报告了 2176 起职业伤害事件,508 名受伤的移民工人报告了 560 起职业伤害事件。每 100 名工人的非致命性发病率为美国出生工人的 4.0%(95%可信区间:3.8%-4.3%),移民工人为 3.0%(95%可信区间:2.6%-3.3%)。77.3%(95%可信区间:75.1%-79.4%)的美国出生工人和 75.6%(95%可信区间:69.8%-80.7%)的移民工人在职业伤害后寻求治疗。在 MEPS 参考期的 2 年内,每名受伤工人的平均医疗支出为美国出生工人 2357 美元,移民工人 2351 美元(2009 年美元,P=0.99)。工人赔偿支付了美国出生工人总支出的 57.0%(95%可信区间:49.4%-63.6%)和移民工人总支出的 43.2%(95%可信区间:33.0%-53.7%)。美国出生工人自付 6.7%(95%可信区间:5.5%-8.3%),移民工人自付 7.1%(95%可信区间:5.2%-9.6%)。

结论

移民工人的非致命性职业伤害发生率明显低于美国出生工人。两组人群在寻求医疗治疗和受伤工人的平均支出方面没有显著差异。移民工人的工人赔偿支付比例(边际显著)小于美国出生工人。

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