From the Office of the Director, Centers for Disease Control and Prevention-National Institute for Occupational Safety and Health, Washington, DC.
J Occup Environ Med. 2013 Dec;55(12):1394-400. doi: 10.1097/JOM.0000000000000030.
Previous research suggests that non-workers' compensation (WC) insurance systems, such as group health insurance (GHI), Medicare, or Medicaid, at least partially cover work-related injury and illness costs. This study further examined GHI utilization and costs.
Using two-part model, we compared those outcomes immediately after injuries for which accepted WC medical claims made zero or positive medical payments.
Controlling for pre-injury GHI utilization and costs and other covariates, our results indicated that post-injury GHI utilization and costs increased regardless of whether a WC medical claim was zero or positive. The increases were highest for zero-cost WC medical claims.
Our national estimates showed that zero-cost WC medical claims alone could cost the GHI $212 million per year.
既往研究表明，非工人赔偿（WC）保险体系，如团体健康保险（GHI）、医疗保险或医疗补助，至少部分覆盖与工作相关的伤害和疾病成本。本研究进一步考察了 GHI 的使用情况和费用。
我们使用两部分模型，比较了那些接受 WC 医疗理赔的零支付或正支付医疗费用的受伤者的 GHI 使用和费用情况。
控制受伤前 GHI 的使用和费用以及其他协变量，我们的结果表明，无论 WC 医疗理赔是零支付还是正支付，受伤后的 GHI 使用和费用都会增加。零成本 WC 医疗理赔的增加幅度最高。
我们的全国估计显示，仅零成本 WC 医疗理赔每年就可能使 GHI 支出 2.12 亿美元。
