Skip Navigation Archive: U.S. Department of Health and Human Services U.S. Department of Health and Human Services
Archive: Agency for Healthcare Research Quality www.ahrq.gov
Archival print banner

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

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

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).


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 visit 57%
Emergency room visit 20%
Out-patient visit 12%
In-patient visit 2%

 

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 (Text Version)). December 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/news/events/conference/2009/berdahl/index.html

 

The information on this page is archived and provided for reference purposes only.

 

AHRQ Advancing Excellence in Health Care