Won Jong-Uk, Seok Hongdeok, Rhie Jeongbae, Yoon Jin-Ha
The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea.; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.; Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea.
Department of Occupational and Environmental Medicine, Dankook University College of Medicine, Cheonan, Korea .
J Korean Med Sci. 2016 May;31(5):695-701. doi: 10.3346/jkms.2016.31.5.695. Epub 2016 Mar 18.
We examined associations between hospital quality in the workers' compensation system and injured patients' return to work after controlling for injury severity, occupational factors, and demographic factors. Return to work data of injured workers were constructed from 2 datasets: 23,392 patients injured in 2009-2011 from the Korea Workers' Compensation & Welfare Service and return to work data from Korea Employment Information Services. After de-identifying the data, quality scores were matched for each hospital that cared for injured patients. Injury severity was measured by Abbreviated Injury Scales. Relative risk and 95% confidence interval were calculated using log binomial regression models. After adjusting for age, sex, injury severity, occupation, factory size, city, and hospital type, the relative risk (95% confidence interval) for the total score was 1.04 (1.02-1.06), 1.06 (1.04-1.09), and 1.07 (1.05-1.10) in the 2(nd), 3(rd), and 4(th) quartiles, respectively, compared to the 1(st) quartile. The RR (95% CI) in the 2(nd), 3(rd), and 4(th) quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1(st) quartile score, respectively. In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.
在控制了损伤严重程度、职业因素和人口统计学因素之后，我们研究了工伤赔偿系统中的医院质量与受伤患者重返工作岗位之间的关联。受伤工人的重返工作数据由两个数据集构建而成：来自韩国工伤赔偿与福利服务机构的2009年至2011年期间受伤的23392名患者，以及来自韩国就业信息服务机构的重返工作数据。在对数据进行去识别处理后，为每家照顾受伤患者的医院匹配了质量得分。损伤严重程度采用简略损伤量表进行测量。使用对数二项回归模型计算相对风险和95%置信区间。在对年龄、性别、损伤严重程度、职业、工厂规模、城市和医院类型进行调整后，与第一四分位数相比，第二、第三和第四四分位数的总分相对风险（95%置信区间）分别为1.04（1.02 - 1.06）、1.06（1.04 - 1.09）和1.07（1.05 - 1.10）。与第一四分位数得分相比，第二、第三和第四四分位数的过程得分的RR（95%CI）分别为1.05（1.02 - 1.07）、1.05（1.02 - 1.08）和1.06（1.04 - 1.09）；结果得分的RR（95%CI）分别为1.02（1.01 - 1.04）、1.05（1.03 - 1.07）和1.06（1.04 - 1.09）。总之，我们采用盲法合并方法的研究设计表明，在控制其他因素后，总体质量、过程质量和结果质量与受伤工人的重返工作岗位有关。
