Cheadle A, Franklin G, Wolfhagen C, Savarino J, Liu P Y, Salley C, Weaver M
Department of Health Services, University of Washington, Seattle 98195.
Am J Public Health. 1994 Feb;84(2):190-6. doi: 10.2105/ajph.84.2.190.
The purpose of this study was to examine factors predictive of duration of work-related disability.
Multivariate survival analysis techniques were used to conduct a population-based, retrospective cohort study on a random sample of 28,473 workers' compensation claims from Washington State filed for injuries occurring in 1987 to 1989. The principal outcome measure was length of time for which compensation for lost wages was paid, used as a surrogate for duration of temporary total disability.
The findings suggest that, even after adjusting for severity of injury, older age, female gender, and a diagnosis of carpal tunnel syndrome or back/neck sprain significantly predict longer duration of disability. Other predictors that were stable and significant, but involved lower magnitudes of effect included divorced marital status, firm size of fewer than 50 employees, higher country unemployment rates, and construction and agricultural work.
Greater disability prevention efforts targeting these higher risk subgroups could have significant economic and public health effects. The greatest impact may be on claimants who remain disabled at 6 months after an injury that did not require hospitalization.
本研究旨在探讨与工伤致残持续时间相关的预测因素。
采用多变量生存分析技术，对华盛顿州1987年至1989年期间因工伤提出的28473份工人赔偿申请的随机样本进行基于人群的回顾性队列研究。主要结局指标是支付工资损失赔偿的时长，以此作为临时完全残疾持续时间的替代指标。
研究结果表明，即使在对损伤严重程度、年龄较大、女性性别以及腕管综合征或背部/颈部扭伤的诊断进行调整之后，这些因素仍显著预测更长的残疾持续时间。其他稳定且显著的预测因素，但其影响程度较小，包括离婚婚姻状况、员工少于50人的公司规模、较高的国家失业率以及建筑和农业工作。
针对这些高风险亚组加大残疾预防力度可能会产生重大的经济和公共卫生影响。最大的影响可能针对那些在受伤后6个月仍残疾且无需住院治疗的索赔者。
