Hashemi L, Webster B S, Clancy E A
Liberty Mutual Research Center for Safety and Health, Hopkinton, MA 01748, USA.
J Occup Environ Med. 1998 Dec;40(12):1110-9. doi: 10.1097/00043764-199812000-00011.
Previously published epidemiologic studies of low back pain (LBP) have reported that the prevalence of low back disability has increased dramatically. These studies based their findings on either the number of disability claims filed, the disability duration, or both. This information was from countries other than the United States or from the US Social Security Disability Insurance data, with findings reported only to the early 1980s. More recent studies of US workers' compensation LBP claims reported a decrease in the incidence rate from the late 1980s to the mid-1990s. No studies have been found that report on the trends of disability duration for workers' compensation LBP claims. This study examined recent trends in the length of disability (LOD) for LBP claims and associated costs, using a large sample of claims from the privately insured US workers' compensation market. LOD and cost information were derived for injuries from 1988, 1990, 1992, 1994, and 1996. For each year, the distributions of LOD and cost were skewed, with the small percentage of claims that lasted more than one year (4.6%-8.8%, depending on the year) accounting for a large percentage of the total disability days (77.6%-90.1%) and cost (64.9%-84.7%). From 1988 to 1996, the average LOD decreased 60.9%, from 156 days to 61 days. The probability of being on disability for a long period of time has decreased over the years. Over the study period, the average cost of a claim decreased 41.4%, while the median cost increased 19.7%. The most influential change in the LOD and cost distributions was a reduction in expensive claims with a long disability duration. The evolution of LOD and cost is also detailed for different disability durations for the study period.
先前发表的关于腰痛（LBP）的流行病学研究报告称，腰痛致残率急剧上升。这些研究的发现基于提交的残疾索赔数量、残疾持续时间或两者。这些信息来自美国以外的国家或美国社会保障残疾保险数据，研究结果仅报告到20世纪80年代初。最近对美国工人赔偿腰痛索赔的研究报告称，从20世纪80年代末到90年代中期，发病率有所下降。尚未发现有研究报告工人赔偿腰痛索赔的残疾持续时间趋势。本研究使用来自美国私人保险工人赔偿市场的大量索赔样本，研究了腰痛索赔的残疾时长（LOD）和相关成本的近期趋势。LOD和成本信息来自1988年、1990年、1992年、1994年和1996年的伤害案例。每年，LOD和成本的分布都呈偏态，持续时间超过一年的索赔比例较小（4.6%-8.8%，取决于年份），但却占总残疾天数的很大比例（77.6%-90.1%）和成本的很大比例（64.9%-84.7%）。从1988年到1996年，平均LOD下降了60.9%，从156天降至61天。多年来，长期残疾的可能性有所降低。在研究期间，索赔的平均成本下降了41.4%，而中位数成本上升了19.7%。LOD和成本分布中最有影响力的变化是减少了残疾持续时间长的昂贵索赔。研究期间还详细说明了不同残疾持续时间的LOD和成本演变情况。
