Webster B S, Snook S H
Liberty Mutual Insurance Company, Hopkinton, MA.
Spine (Phila Pa 1976). 1994 May 15;19(10):1111-5; discussion 1116. doi: 10.1097/00007632-199405001-00001.
Cost data were gathered from computerized records of the Liberty Mutual Insurance Company for low back pain workers' compensation claims (N = 119,107) and for all claims (N = 731,087) initiated from 45 jurisdictions (states) during 1989.
This study provided more current, accurate, and additional information to estimate the costs and incidence associated with compensable low back pain compared with all compensation claims.
The first group of data included all compensable low back claims selected by specific codes: body part codes consisted of low back area, sacrum and coccyx, disc, and multiple trunk; injury codes consisted of strain, sprain, inflammation, rupture, hernia, fracture, and contusion. The second sample included all compensable claims, including both occupational injuries and illnesses.
Low back pain cases represented 16% of all claims but 33% of all claims costs; 55.4% of the low back pain cases received medical payments only (i.e., did not receive indemnity payments for lost time). The mean cost per case for low back pain was $8321; median cost per case was $396. Medical costs represented 32.4% of the total costs; indemnity costs (i.e., payment for lost time) represented 65.8%.
Since indemnity costs represent the greatest percentage of workers' compensation expenditure, the primary goal of low back pain management should be the prevention or reduction of prolonged disability.
成本数据来自利宝互助保险公司的计算机记录,涉及1989年期间45个司法管辖区(州)发起的腰痛工伤赔偿索赔(N = 119,107)和所有索赔(N = 731,087)。
与所有赔偿索赔相比,本研究提供了更新、更准确和更多的信息,以估计与可补偿性腰痛相关的成本和发病率。
第一组数据包括通过特定代码选择的所有可补偿性腰痛索赔:身体部位代码包括下背部区域、骶骨和尾骨、椎间盘以及多个躯干;损伤代码包括拉伤、扭伤、炎症、破裂、疝气、骨折和挫伤。第二个样本包括所有可补偿性索赔,包括职业伤害和疾病。
腰痛病例占所有索赔的16%,但占所有索赔成本的33%;55.4%的腰痛病例仅获得医疗费用支付(即未获得误工赔偿)。腰痛病例的平均每例成本为8321美元;每例中位数成本为396美元。医疗成本占总成本的32.4%;赔偿成本(即误工赔偿)占65.8%。
由于赔偿成本在工伤赔偿支出中占比最大,腰痛管理的主要目标应该是预防或减少长期残疾。