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多辖区工伤赔偿统一数据库的开发与初步应用

Development and initial application of a harmonised multi-jurisdiction work injury compensation database.

作者信息

Di Donato Michael, Sheehan Luke R, Gray Shannon, Iles Ross, van Vreden Caryn, Collie Alex

机构信息

Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

出版信息

Digit Health. 2023 Jun 4;9:20552076231176695. doi: 10.1177/20552076231176695. eCollection 2023 Jan-Dec.

Abstract

OBJECTIVES

Workers' compensation schemes provide funding for wage replacement and healthcare for injured and ill workers. In Australia, workers' compensation schemes operate independently in different jurisdictions, making comparisons of health service use challenging. We sought to develop and deploy a new database of health service and income support data, harmonising data from multiple Australian workers' compensation jurisdictions.

METHODS

We worked with workers' compensation authorities from six Australian jurisdictions to combine claims, healthcare, medicines and wage replacement data for a sample of compensated workers with claims for musculoskeletal conditions. We designed a structured relational database and developed a bespoke health services coding scheme to harmonise data across jurisdictions.

RESULTS

The Multi-Jurisdiction Workers' Compensation Database contains four data sets: claims, services, medicines and wage replacement. The claims data set contains 158,946 claims for low back pain (49.6%), limb fracture (23.8%) and non-specific limb conditions (26.7%). The services data set contains a total of 4.2 million cleaned and harmonised services including doctors (29.9%), physical therapists (56.3%), psychological therapists (2.8%), diagnostic procedures (5.5%) and examinations and assessments (5.6%). The medicines data set contains 524,380 medicine dispenses, with 208,504 (39.8%) dispenses for opioid analgesics.

CONCLUSIONS

The development of this database presents potential opportunities to gain a greater understanding of health service use in the Australian workers' compensation sector, to measure the impact of policy change on health services and to provide a method for further data harmonisation. Future efforts could seek to conduct linkage with other data sources.

摘要

目标

工人补偿计划为受伤和患病工人提供工资替代和医疗保健资金。在澳大利亚,工人补偿计划在不同司法管辖区独立运作,这使得比较医疗服务使用情况具有挑战性。我们试图开发并部署一个新的医疗服务和收入支持数据库,整合来自澳大利亚多个工人补偿司法管辖区的数据。

方法

我们与澳大利亚六个司法管辖区的工人补偿当局合作,合并了针对肌肉骨骼疾病提出索赔的受补偿工人样本的索赔、医疗保健、药品和工资替代数据。我们设计了一个结构化关系数据库,并开发了一个定制的医疗服务编码方案,以跨司法管辖区统一数据。

结果

多司法管辖区工人补偿数据库包含四个数据集:索赔、服务、药品和工资替代。索赔数据集包含158,946份针对腰痛(49.6%)、肢体骨折(23.8%)和非特异性肢体疾病(26.7%)的索赔。服务数据集总共包含420万条清理和统一后的服务记录,包括医生(29.9%)、物理治疗师(56.3%)、心理治疗师(2.8%)、诊断程序(5.5%)以及检查和评估(5.6%)。药品数据集包含524,380次药品配给,其中208,504次(39.8%)为阿片类镇痛药配给。

结论

该数据库的开发为更深入了解澳大利亚工人补偿部门的医疗服务使用情况、衡量政策变化对医疗服务的影响以及提供进一步数据统一方法带来了潜在机会。未来的努力可以寻求与其他数据源建立联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fff2/10259130/341c00bf4d4b/10.1177_20552076231176695-fig1.jpg

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