在路易斯安那州的一组受伤工人中，联合使用阿片类药物和手术程序对工人赔偿费用的影响。

Impact of the combined use of opioids and surgical procedures on workers' compensation cost among a cohort of injured workers in the state of Louisiana.

机构信息

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

出版信息

J Occup Environ Med. 2012 Dec;54(12):1513-9. doi: 10.1097/JOM.0b013e3182664866.

DOI:10.1097/JOM.0b013e3182664866

PMID:23018525

Abstract

OBJECTIVE

To determine the impact of surgical procedures and opioids on workers' compensation claim cost.

METHODS

A cohort of 11,394 lost time claims filed with the Louisiana Workers' Compensation Corporation from 1999 to 2002 was followed for 7 years.

RESULTS

Controlling for gender, attorney involvement, and claim duration, multivariate logistic regression analysis indicated that odds ratios (ORs) for a catastrophic claim (final cost ≥ $100,000) associated with short-acting and long-acting opioids (vs no opioids) were 4.28 and 12.19. The ORs for catastrophic claims associated with a spinal surgical procedure or spinal fusion (vs no procedure) were 4.27 and 11.40. Spinal surgical procedures plus opioid use significantly increased the OR for catastrophic claims; for example, spinal fusion plus long-acting opioids had an OR of 138.96.

CONCLUSION

Spinal surgery and opioid utilization are associated with catastrophic claim costs.

摘要

目的

确定手术程序和阿片类药物对工人赔偿索赔成本的影响。

方法

对 1999 年至 2002 年期间向路易斯安那工人赔偿公司提交的 11394 份超时索赔进行了为期 7 年的随访。

结果

在控制性别、律师参与和索赔期限的情况下，多变量逻辑回归分析表明，与短期和长效阿片类药物（与无阿片类药物相比）相关的灾难性索赔（最终费用≥$100000）的比值比（OR）分别为 4.28 和 12.19。与脊柱手术或脊柱融合（与无手术相比）相关的灾难性索赔的 OR 分别为 4.27 和 11.40。脊柱手术加阿片类药物的使用显著增加了灾难性索赔的 OR；例如，脊柱融合加长效阿片类药物的 OR 为 138.96。