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Burden of Medical Cost of Workplace Injuries among Hospital Workers

Burden of Medical Cost of Workplace Injuries among Hospital Workers. Hyun Kim, Jonathan Dropkin, Francine Smith, and Jacqueline Moline Hofstra North Shore-LIJ School of Medicine North Shore-LIJ Health System. Presenter Disclosures. Hyun Kim.

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Burden of Medical Cost of Workplace Injuries among Hospital Workers

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  1. Burden of Medical Cost of Workplace Injuries among Hospital Workers Hyun Kim, Jonathan Dropkin, Francine Smith, and Jacqueline Moline Hofstra North Shore-LIJ School of Medicine North Shore-LIJ Health System

  2. Presenter Disclosures Hyun Kim (1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: No relationships to disclose (2) My presentation will include discussion of “off-label” use of the following: No relationships to disclose

  3. U.S. Bureau of Labor Statistics report (2010) • Musculoskeletal disorders (MSDs) accounted for 28% of all workplace injuries and illnesses requiring time away from work • Among all occupations, psychiatric aides had the highest incidence rate of 226 MSDs per 10,000 full-time workers (FTW), followed by emergency medical technicians and paramedics (234 MSDs/10,000 FTW), with an average rate of 33 MSDs per 10,000 FTW

  4. What about costs for MSDs among healthcare workers? • Back injuries alone are estimated to be $20 billion annually (OSHA) • Average $6,837 (median $428) per WC claim in Washington State (1990-1998) • No study has directly evaluated burden of costs from MSDs among healthcare workers

  5. Objective • We investigated MSDs and its medical costs among 47,343 employees in the health system during 2003-2007 • North Shore-Long Island Jewish Health System consists of 15 community and tertiary hospitals in NYC, Staten Island, and Long Island in NYS

  6. Methods • Only claims accepted and reimbursed medical expenses from Institutional WC claims from 2003 to 2009 were included • MSDs were identified using ICD-9 codes reported to health insurance (Dunning, 2010) • Age, gender, occupation, union membership, scheduled shift, and employment status were obtained

  7. Methods • Index searching program for occupation was developed in Stata, and validated by manually reviewing with uncoded data • To investigate potential determinants of medical cost expenses, multivariable zero truncated negative binomial regression model was used

  8. 60 40 Cumulative # of claims in x-scale 20 0 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 Medical cost ($10,000) Poisson with long tail and no zero Mean: $6229 Median: $1313 Overdispersion parameter Alpha: 2.5

  9. Results • Among 47,343 workers, 3,452 (7.3%) WC cases had their medical expenses reimbursed • Average medical cost reimbursed was $6,229 (median: $1,313) • 76% of these WC cases were MSDs • Average cost for MSDs($7560) was 3.7 times more than non-MSDs claims ($2,037) • Median cost for MSDs ($1,960) was 4.4 times more than non-MSDs claims ($443)

  10. MSDs Medical Cost by Age

  11. MSDs Medical Cost by Gender

  12. MSDs Medical Cost by Occupation

  13. MSDs Medical Cost by Union Membership

  14. MSDs Medical Cost by Shift

  15. MSDs Medical Cost by Job status

  16. MSDs Medical Cost by Patient Handling MSDs or not

  17. MSDs Medical Cost by body region

  18. MSDs Medical Cost by Cause of Injury

  19. Comparison determinants between MSDs and medical cost for MSDs

  20. Comparison determinants between MSDs and medical cost for MSDs

  21. Comparison determinants between MSDs and medical cost for MSDs

  22. Comparison determinants between MSDs and medical cost for MSDs

  23. Discussion • If you are over 60 yr old (median $3,000), female ($2,157), medical tech ($2,811), union member ($2,346), evening shift ($2,934), and part-time hospital worker, then watch out! • Although the chance to get MSDs is lower than other workers (RR=0.6 for 60 or older, RR=0.9 for female, RR=1 for med tech, RR=1 for union, RR=1 for evening shift, RR=0.8 for part-time)

  24. Discussion • Aging was a unique, strong factor for increasing medical costs, while it was a strong factor for decreasing MSDs • The increased association with age may be due to the increasing risk of developing more severe MSDs with age, resulting from cumulative exposure of dose or slower recovery time than younger group

  25. Limitation • WC is not designed for epidemiologic investigation • Better understanding is required to explain why certain factors showed association with medical cost, such as union membership, job status, and occupation • Few studies conducted an economic analysis with WC among hospital workers, so we lack a comparison group

  26. Conclusion • Prevention of MSDs should also consider factors that increase cost of medical treatment for MSDs • Especially for the aging workforce

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