Wong Jessica J, McGregor Marion, Mior Silvano A, Loisel Patrick
Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and the Canadian Memorial Chiropractic College (CMCC), Toronto, Ontario, Canada.
Director of Education, Year II, Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.
J Manipulative Physiol Ther. 2014 Jan;37(1):7-21. doi: 10.1016/j.jmpt.2013.07.009. Epub 2013 Nov 12.
The purpose of this study was to develop a model that evaluates the impact of policy changes on the number of workers' compensation lost-time back claims in Ontario, Canada, over a 30-year timeframe. The model was used to test the hypothesis that a theory- and policy-driven model would be sufficient in reproducing historical claims data in a robust manner and that policy changes would have a major impact on modeled data.
The model was developed using system dynamics methods in the Vensim simulation program. The theoretical effects of policies for compensation benefit levels and experience rating fees were modeled. The model was built and validated using historical claims data from 1980 to 2009. Sensitivity analysis was used to evaluate the modeled data at extreme end points of variable input and timeframes. The degree of predictive value of the modeled data was measured by the coefficient of determination, root mean square error, and Theil's inequality coefficients.
Correlation between modeled data and actual data was found to be meaningful (R(2) = 0.934), and the modeled data were stable at extreme end points. Among the effects explored, policy changes were found to be relatively minor drivers of back claims data, accounting for a 13% improvement in error. Simulation results suggested that unemployment, number of no-lost-time claims, number of injuries per worker, and recovery rate from back injuries outside of claims management to be sensitive drivers of back claims data.
A robust systems-based model was developed and tested for use in future policy research in Ontario's workers' compensation. The study findings suggest that certain areas within and outside the workers' compensation system need to be considered when evaluating and changing policies around back claims.
本研究的目的是开发一个模型，以评估政策变化对加拿大安大略省30年时间范围内工伤赔偿损失工时追溯索赔数量的影响。该模型用于检验以下假设：一个基于理论和政策驱动的模型能够以稳健的方式再现历史索赔数据，并且政策变化会对模型数据产生重大影响。
该模型是使用Vensim模拟程序中的系统动力学方法开发的。对赔偿福利水平和经验费率政策的理论效果进行了建模。该模型使用1980年至2009年的历史索赔数据构建并验证。敏感性分析用于评估可变输入和时间范围极端端点处的模型数据。模型数据的预测价值程度通过决定系数、均方根误差和泰尔不平等系数来衡量。
发现模型数据与实际数据之间的相关性有意义（R(2)=0.934），并且模型数据在极端端点处是稳定的。在所探讨的影响因素中，政策变化被发现是追溯索赔数据的相对较小驱动因素，误差改善了13%。模拟结果表明，失业、无损失工时索赔数量、每名工人受伤数量以及索赔管理之外的背部损伤恢复率是追溯索赔数据的敏感驱动因素。
开发并测试了一个稳健的基于系统的模型，用于安大略省工伤赔偿未来的政策研究。研究结果表明，在评估和改变围绕追溯索赔的政策时，需要考虑工伤赔偿系统内外的某些领域。
