Macpherson Robert A, Koehoorn Mieke, Neis Barbara, McLeod Christopher B
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Occup Environ Med. 2021 Jan 27. doi: 10.1136/oemed-2020-106917.
To examine whether differences in work disability duration between out-of-province and within-province workers differed by industry and jurisdictional context.
Workers' compensation data were used to identify comparable lost time, work-related injury and musculoskeletal disorder claims accepted in six Canadian jurisdictions between 2006 and 2015. Out-of-province workers were identified as workers who filed claims in a different provincial jurisdiction to their province of residence. Coarsened exact matching was used to match out-of-province workers with within-province workers based on observable characteristics. Quantile regression models were used to estimate differences in cumulative disability days paid between out-of-province workers and within-province workers at different percentiles in the disability distribution, adjusting for confounders.
Compared with within-province workers, out-of-province workers were paid more disability days even after matching and adjusting on observable characteristics. Differences between the two groups of workers were observed for short-duration, medium-duration and long-duration claims (differences of 1.57, 6.39, 21.42, 46.43 days at the 25th, 50th, 75th and 90th percentiles, respectively). Industry-specific models showed that differences were largest in construction, transportation and warehousing, and mining, quarrying and oil and gas extraction. Jurisdiction-specific models showed that differences were largest in the western provinces where out-of-province workers were concentrated in those sectors.
Out-of-province workers are a vulnerable group with respect to risk of longer work disability duration. Workers' compensation systems, employers and healthcare providers may need to tailor specific interventions for these types of workers, particularly those employed in resource economy-dependent regions that are far from their regions of residence.
研究省外和省内工人在工伤致残持续时间上的差异是否因行业和司法管辖区背景而异。
利用工人赔偿数据，识别2006年至2015年期间加拿大六个司法管辖区内可比的误工时间、与工作相关的伤害及肌肉骨骼疾病索赔。省外工人被定义为在其居住省份以外的省级司法管辖区提出索赔的工人。使用粗化精确匹配方法，根据可观察特征将省外工人与省内工人进行匹配。采用分位数回归模型，在调整混杂因素的情况下，估计省外工人和省内工人在残疾分布不同百分位数处累积支付的残疾天数差异。
与省内工人相比，即使在根据可观察特征进行匹配和调整后，省外工人获得的残疾天数支付仍更多。在短期、中期和长期索赔中观察到两组工人之间存在差异（在第25、50、75和90百分位数处的差异分别为1.57、6.39、21.42、46.43天）。特定行业模型显示，建筑、运输和仓储以及采矿、采石和石油与天然气开采行业的差异最大。特定司法管辖区模型显示，在省外工人集中在这些行业的西部省份，差异最大。
就工伤致残持续时间较长的风险而言，省外工人是弱势群体。工人赔偿制度、雇主和医疗保健提供者可能需要针对这类工人制定具体干预措施，特别是那些受雇于远离其居住地区的资源经济依赖地区的工人。
