Lipscomb Hester J, Schoenfisch Ashley L, Cameron Wilfrid, Kucera Kristen L, Adams Darrin, Silverstein Barbara A
Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina.
Strategic Solutions for Safety, Health and Environment, Seattle, Washington.
Am J Ind Med. 2015 Sep;58(9):955-63. doi: 10.1002/ajim.22455. Epub 2015 May 4.
Musculoskeletal symptoms and disorders (MSDIs) are common reasons for visits to medical providers in the general population and they are common work-related complaints. Prior reports raise concerns as to whether declines in workers' compensation (WC) rates represent true improvement in occupational health and safety or shifting of care to other payment systems.
By linking administrative records, we compared patterns of WC claims and private health care utilization for disorders of the upper extremity (UE) and knee among a large cohort of union carpenters over a 20-year period.
As WC claim rates declined, private health care utilization increased. The increase was muted somewhat but sustained when adjusting for other patterns of health care utilization.
Findings suggest the decline of WC claim rates do not solely represent improved occupational safety in this population, but also a considerable shifting of care to their private insurance coverage over time.
肌肉骨骼症状和疾病（MSDIs）是普通人群就医的常见原因，也是常见的与工作相关的投诉。先前的报告引发了人们对工伤赔偿（WC）率下降是否代表职业健康与安全的真正改善，还是医疗护理转移到其他支付系统的担忧。
通过关联行政记录，我们比较了一大群工会木匠在20年期间上肢（UE）和膝盖疾病的工伤赔偿申请模式与私人医疗保健利用模式。
随着工伤赔偿申请率下降，私人医疗保健利用率上升。在调整其他医疗保健利用模式后，这种上升有所缓和但仍持续。
研究结果表明，工伤赔偿申请率的下降并不完全代表该人群职业安全性的提高，随着时间推移，还意味着相当一部分医疗护理转移到了他们的私人保险范围内。
