Distinctive emergency department usage for injury for workers' compensation cases in Utah in 1996

Emergency department visits for work-related injuries

BACKGROUND

Work-related injuries are commonly seen in the emergency department (ED). This study sought to analyze characteristics of ED patient visits that were billed under workers' compensation.

METHODS

This was a retrospective chart review of visits during 2015 that were billed under workers' compensation at an academic ED. The following variables were collected: age, gender, mechanism of injury/exposure, diagnoses, imaging performed, specialty consultation, operative requirement, follow-up specialty, and ED disposition.

RESULTS

In 2015, 377 patients presented to the ED for work-related injuries. The most common mechanism of injury was fall. Frequent diagnoses included lower extremity injuries and hand/finger injuries. The most common consulting service was orthopedics. Only five patients were referred to occupational medicine for follow up.

CONCLUSION

Knowledge of the types of occupational injuries and subsequent care required may help guide both workers and employers how to best triage patients within the healthcare system. Alternative settings such as occupational medicine or primary care services may be appropriate for some patients.

Inpatient hospital care for work-related injuries and illnesses

BACKGROUND

The aim of this study was to compile nationally representative statistics describing inpatient hospital care for patients with work-related injuries and illnesses covered under workers' compensation (WC) insurance in the United States.

METHODS

Three years of data (1997-1999) from the Nationwide Inpatient Sample (NIS) were used to describe WC inpatient stays with respect to patient and hospital characteristics, principal diagnoses, number and type of procedures provided, total charges, length of stay, and time from admission to administering of the principal procedure.

RESULTS

Approximately 209,139 WC hospitalizations occurred annually, representing 0.62% of all inpatient admissions. The average total charge per WC hospitalization was 14,966 dollars. After adjusting for the type of diagnosis and other factors, WC hospital care was found to involve 13-24% more procedures, have a slightly longer (4%) length of stay, and take 23-54% less time from admission to the principal procedure than inpatient care for comparable diagnoses paid by other sources. Inpatient care for disc and spinal disorders paid by WC had 16% higher charges than similar non-WC cases. Three-year trends showed a steady decline in the number of WC hospitalizations between 1997 and 1999 but a sharp 16% rise in total charges per WC stay.

CONCLUSIONS

This research provides an initial foundation for understanding the extent and nature of hospitalized care for injured workers in the US and identifying significant trends in the delivery of care.

Occupational injury and illness surveillance: conceptual filters explain underreporting

Occupational health surveillance data are key to effective intervention. However, the US Bureau of Labor Statistics survey significantly underestimates the incidence of work-related injuries and illnesses. Researchers supplement these statistics with data from other systems not designed for surveillance. The authors apply the filter model of Webb et al. to underreporting by the Bureau of Labor Statistics, workers' compensation wage-replacement documents, physician reporting systems, and medical records of treatment charged to workers' compensation. Mechanisms are described for the loss of cases at successive steps of documentation. Empirical findings indicate that workers repeatedly risk adverse consequences for attempting to complete these steps, while systems for ensuring their completion are weak or absent.