工伤赔偿数据未涵盖的与工作相关的致命和住院伤害的特征。
Characteristics of work-related fatal and hospitalised injuries not captured in workers' compensation data.
作者信息
Koehoorn M, Tamburic L, Xu F, Alamgir H, Demers P A, McLeod C B
机构信息
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Occupational Health, School of Public Health, The University of Texas Health Science Center, San Antonio, Texas, USA.
出版信息
Occup Environ Med. 2015 Jun;72(6):413-20. doi: 10.1136/oemed-2014-102543. Epub 2015 Feb 23.
OBJECTIVES
(1) To identify work-related fatal and non-fatal hospitalised injuries using multiple data sources, (2) to compare case-ascertainment from external data sources with accepted workers' compensation claims and (3) to investigate the characteristics of work-related fatal and hospitalised injuries not captured by workers' compensation.
METHODS
Work-related fatal injuries were ascertained from vital statistics, coroners and hospital discharge databases using payment and diagnosis codes and injury and work descriptions; and work-related (non-fatal) injuries were ascertained from the hospital discharge database using admission, diagnosis and payment codes. Injuries for British Columbia residents aged 15-64 years from 1991 to 2009 ascertained from the above external data sources were compared to accepted workers' compensation claims using per cent captured, validity analyses and logistic regression.
RESULTS
The majority of work-related fatal injuries identified in the coroners data (83%) and the majority of work-related hospitalised injuries (95%) were captured as an accepted workers' compensation claim. A work-related coroner report was a positive predictor (88%), and the responsibility of payment field in the hospital discharge record a sensitive indicator (94%), for a workers' compensation claim. Injuries not captured by workers' compensation were associated with female gender, type of work (natural resources and other unspecified work) and injury diagnosis (eg, airway-related, dislocations and undetermined/unknown injury).
CONCLUSIONS
Some work-related injuries captured by external data sources were not found in workers' compensation data in British Columbia. This may be the result of capturing injuries or workers that are ineligible for workers' compensation, or the result of injuries that go unreported to the compensation system. Hospital discharge records and coroner reports may provide opportunities to identify workers (or family members) with an unreported work-related injury and to provide them with information for submitting a workers' compensation claim.
目的
（1）利用多种数据来源识别与工作相关的致命和非致命住院伤害；（2）比较外部数据来源的病例确诊情况与已受理的工伤赔偿申请；（3）调查工伤赔偿未涵盖的与工作相关的致命和住院伤害的特征。
方法
使用支付和诊断代码以及伤害和工作描述，从生命统计数据、验尸官和医院出院数据库中确定与工作相关的致命伤害；使用入院、诊断和支付代码从医院出院数据库中确定与工作相关的（非致命）伤害。将1991年至2009年从上述外部数据来源确定的15至64岁不列颠哥伦比亚省居民的伤害情况与已受理的工伤赔偿申请进行比较，采用捕获百分比、效度分析和逻辑回归。
结果
验尸官数据中确定的大多数与工作相关的致命伤害（83%）和大多数与工作相关的住院伤害（95%）被作为已受理的工伤赔偿申请。与工作相关的验尸官报告是工伤赔偿申请的阳性预测指标（88%），医院出院记录中的支付责任字段是敏感指标（94%）。未被工伤赔偿涵盖的伤害与女性性别、工作类型（自然资源和其他未明确的工作）以及伤害诊断（如气道相关、脱位和未确定/未知伤害）有关。
结论
不列颠哥伦比亚省外部数据来源捕获到的一些与工作相关的伤害在工伤赔偿数据中未被发现。这可能是由于捕获了不符合工伤赔偿资格的伤害或工人，或者是由于伤害未向赔偿系统报告。医院出院记录和验尸官报告可能提供机会识别有未报告的与工作相关伤害的工人（或家庭成员），并为他们提供提交工伤赔偿申请所需的信息。
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