Medical Care Utilization for Work-related Injury Health Conditions in the United States 2002-2006

Slide presentation from the AHRQ 2009 conference.

On September 16, 2009, Terceira Berdahl made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (894 KB) (Plugin Software Help).


Slide 1

Slide 1. Medical Care Utilization for Work-related Injury Health Conditions in the United States, 2002-2006

Medical care utilization for work-related injury health conditions in the United States 2002-2006

By Terceira A. Berdahl, PhD Agency for Healthcare Research and Quality Email: terceira.berdahl@ahrq.hhs.gov
and
Marc Zodet, MS.Agency for Healthcare Research and Quality Email: marc.zodet@ahrq.hhs.gov

 

Slide 2

Slide 2. Focus of Our Talk

Focus of our talk

  • Workplace injuries and medical care
    • Provide descriptive estimates of medical care for work injuries
    • Examine racial-ethnic/gender disparities in work injuries
    • Exploring racial-ethnic/gender disparities in health care utilization

 

Slide 3

Slide 3. Background

Background

  • 24 percent of workers experience work injuries at some point in their mid-careers.
  • Work injuries are common and account for 30% of medically treated injuries in the United States.
  • Of the millions of workers who are injured on the job each year, many seek healthcare.

 

Slide 4

Slide 4. Background

Background

  • Prior research on occupational health disparities finds inconsistent patterns of racial-ethnic and gender differences.
  • Minority workers earn lower wages, disproportionately employed in low skilled jobs, over-represented in the most dangerous occupations.

 

Slide 5

Slide 5. Medical Care for Work Injuries

Medical Care for Work Injuries

  • A large body of prior research documents racial-ethnic/gender disparities in healthcare access and utilization.
  • Little research on healthcare access/use disparity patterns for injured workers.

 

Slide 6

Slide 6. Current Study

Current study

  • We examine work injuries and healthcare utilization.
  • Nationally representative survey data from the Medical Expenditure Panel Survey (2002-2006).
  • Sample includes broad age ranges, occupations, and industries.

 

Slide 7

Slide 7. Research Questions: Current Study

Research Questions: Current Study

  • What kinds of healthcare do individuals use when they suffer from work-related health problems?
  • Do racial-ethnic/gender disparities exist for reporting a work-injury related health problem?
  • Do racial-ethnic/gender disparities exist for treatment seeking among individuals who report being bothered by a work-related injury?

 

Slide 8

Slide 8. Data and Sample

Data and Sample

  • Medical Expenditure Panel Survey (MEPS).
  • National probability sample survey that is representative of the U.S. civilian non-institutionalized population.
  • Workers aged 18 and older.
  • To enhance the statistical power of the study we pooled cross-sectional MEPS data from years 2002-06. Thus, our findings represent the average annual odds of reporting a workplace injury and seeking treatment. We also present estimates of the total dollars spent on healthcare associated with these work-related injuries across all 5 years.

 

Slide 9

Slide 9. Outcome Measures

Outcome measures

  • Descriptive
    • Medical Expenditures. Total expenditures and types of treatment.
  • Modeling
    • Workplace Injury. A dichotomous measure of having any workplace accident/injury related condition in the past year.
    • Healthcare Utilization. A dichotomous measure that is coded "1" if the person had any office-based, outpatient, emergency department, or inpatient services for a work injury and coded "0" if otherwise.

 

Slide 10

Slide 10. Independent Variables

Independent Variables

  • Race-ethnicity/sex subgroups. Race, ethnicity, and sex were used to create eight analysis subpopulations: White non-Hispanic men; black non-Hispanic men; other non-Hispanic men; Hispanic men; white women; black women; other race women; Hispanic women.
  • Age. Four age categories: 18-24 years, 25-44 years, 45-64 years, and 65+ years.
  • Education. Three categories: less than high school, high school, or more than high school.
  • Occupation & Industry. Occupation consists of US Census 9-category occupation codes and 14-category industry codes.
  • Insurance Status. Individuals are coded as having private insurance, public insurance, or no health insurance.

 

Slide 11

Slide 11. Analysis

Analysis

  • We perform descriptive and multivariate statistical analysis using STATA 10.0.
  • Descriptive statistics on healthcare use, types of use, total expenditures for work injuries.
  • Two sets of logistic regression models predicting
    • 1) the odds of work injury
    • 2) the odds of seeking treatment at selected points of service
  • All estimates are weighted using the appropriate year sample weight and all estimates include standard errors adjusted for complex survey design.

 

Slide 12

Slide 12. Descriptive Findings

Descriptive Findings

  • Work related injuries comprised approximately 17% of all injury related medical conditions.
  • Of workers aged 18 and over, 6% reported being bothered by a work-related health problem.
  • Individuals with work injury-related conditions spend $1,843 on average per year for those medical expenses.

 

Slide 13

Slide 13. Descriptive findings . . .

Descriptive findings.

  • During the years 2002-2006, a total of $85.9 billion were spent on office-based, outpatient, emergency department, and inpatient services for workplace injuries.
  • Among people with work injuries, nearly 40% of their total healthcare expenses were for work-related conditions.

 

Slide 14

Slide 14. What kinds of healthcare do individuals use when they suffer from work-related health problems?

What kinds of healthcare do individuals use when they suffer from work-related health problems?

Type of care received% of injured workers
Office based visit57%
Emergency room visit20%
Out-patient visit12%
In-patient visit2%

 

Slide 15

Slide 15. Multivariate Findings

Multivariate Findings

  • Logistic regression models predicting
    • The odds of reporting a work injury
    • The odds of seeking treatment among those with work injuries

 

Slide 16

Slide 16. Do racial-ethnic/gender disparities exist for reporting a work injury related health problem?

Do racial-ethnic/gender disparities exist for reporting a work injury related health problem?

Figure 1: Predicted probability of injury in adjusted models (models control for age, education, occupation, and industry).
 

 

Slide 17

Slide 17. Variables Associated with Work Injury

Variables associated with work injury

  • Education: higher educated workers had lower risk.
  • Age: middle age categories are significantly more likely to be injured compared to young adults (age 18-24).
  • Occupation: decreased risk for manager, services, sales and professional, increased risk for construction.
  • Industry: increased risk for natural resources, construction, decreased risk for finance, professional and service work.

 

Slide 18

Slide 18. Do racial-ethnic/gender disparities exist for treatment seeking among individuals who report being bothered by a work-related injury?

Do racial-ethnic/gender disparities exist for treatment seeking among individuals who report being bothered by a work-related injury?

Figure 2: Predicted probability of seeking treatment adjusted models (models controlling for age, education, occupation, and industry).
 

 

Slide 19

Slide 19. Variables Associated with Healthcare Use

Variables associated with healthcare use

  • Age: the odds of seeking treatment oldest workers (age +65) were 46% lower compared to young adult workers (age 18-24) to seek treatment.
  • Education: had no significant association with treatment seeking
  • Occupation: had no significant association with treatment seeking
  • Industry: had no significant association with treatment seeking
  • Health Insurance: The odds of seeking treatment for uninsured workers were 33% lower compared to privately insured workers. We found no statistically significant difference between publicly and privately insured workers.

 

Slide 20

Slide 20. Discussion

Discussion

  • We find some evidence of racial-ethnic/gender disparities in reporting work-related health conditions.
    • White men have greatest risk of injury.
      • Black and Hispanic men had significantly lower risk.
      • Women had significantly lower risk.

 

Slide 21

Slide 21. Discussion

Discussion

  • Health care use for workplace injury conditions.
    • Less evidence of racial-ethnic gaps.
      • White women more likely to see a doctor compared to white men.
    • Older workers with work injuries less likely to seek treatment.
    • Uninsured workers do not seek treatment at comparable rates-this may be an indicator of health care access barriers for workers without health insurance.

 

Slide 22

Slide 22. Conclusion

Conclusion

  • Work injuries are costly to the health care system.
  • Most workers with work-related injuries seek some form of healthcare treatment.
  • Our utilization findings are exploratory first step. They suggest that access disparities may influence how people seek treatment for work-injury health problems.
  • Given persistent disparities in employment outcomes and healthcare access, it is important to examine how racial-ethnic/gender differences shape work injury risk and healthcare use.
Current as of December 2009
Internet Citation: Medical Care Utilization for Work-related Injury Health Conditions in the United States 2002-2006. December 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/conference/2009/berdahl/index.html