Health Care Utilization for Musculoskeletal Back Disorders, Washington State Union Carpenters, 1989–2003

Abstract

Patterns of utilization across private and workers' compensation delivery systems are not independent; we need to look broadly at sources of health care coverage to better understand the health of working populations.

Contrasting patterns of care for musculoskeletal disorders and injuries of the upper extremity and knee through workers' compensation and private health care insurance among union carpenters in Washington State, 1989 to 2008

“…These patterns over time are consistent with the shifting of care for work‐related MSDIs of the UE and knee outside of the WC system to other payment sources, namely the private health insurance system, a concern that has been reported before [Dong et al, ; Lipscomb et al, ,; Schoenfisch et al, ]. However, these data alone do not provide insight into the factors influencing such patterns, their degree of influence, and whether their impact varies over time or worker characteristics.…”

“…Previous analyses of back injuries and disorders among union carpenters document a marked decline in the yearly rates of back disorders treated through workers' compensation over time [Lipscomb et al, ; Lipscomb et al, ]. This pattern was accompanied by an increase in treatment and associated costs of the same disorders as captured through the carpenters' private health insurance—available to provide care for non work‐related conditions.…”

Effectiveness of OSHA Outreach Training on carpenters’ work‐related injury rates, Washington State 2000–2008

“…In another, more than one quarter of plumbing and pipefitting journeymen acknowledged suffering a workplace injury they did not report [Taylor et al, ]. Recent research suggests insured construction workers rely, in part, on private health insurance for occupational hazards of their trade, rather than filing a WC claim [Lipscomb et al, ,, ; Schoenfisch et al, ; Dale et al, ].…”

Transfer of the health care burden of occupational injuries and diseases from labor insurance to national health insurance in Taiwan

“…For instance, in the United States, Medicare and Medicaid were estimated to have absorbed 10.7% and 8.15% of total medical spending for occupational injuries and diseases, respectively . Studies from the United States have suggested that medical care for work‐related conditions has increasingly been sought outside of the worker compensation system . In other words, the economic burden of work‐related injuries and diseases may be unjustly transferred from the employer, who is the major financial contributor to workers’ compensation, to individual workers or tax‐funded health care systems.…”