|
|
|
|
|
|
|
NOTE: This document is provided for historical purposes only.
The authors ask you:
The MarketScan Health and Productivity Management (HPM) Database and the Commercial Claims and Encounters (CCE) Database will be used to compare rates and costs of certain illnesses and injuries among industrial sectors and determine whether individuals with a certain injury or illness may receive care for the same condition or episode under workers' compensation (WC), group medical insurance, and short-term disability (STD) insurance. This will provide some evidence about the numbers of work-related cases being completely missed or only being partially paid by WC but contributing to the cost of the other programs. Collaboration and coordination with partners outside NIOSH will be pursued to complement and enhance the utility of the proposed project.
Past work using HPM data: HPM data have not been used to compare rates and costs of disease and injury by industry, or to focus on the relationship between WC and other costs in order to better identify occupational illness and injury costs. Previous work using HPM data estimated the ten most costly conditions for employers, and results were broken down by absences, medical claims, and STD (but not WC). The most recent related work was published in 2004 using data from 1999 (Goetzel et al).
Past partner work: The Integrated Benefits Institute (IBI), a current NIOSH partner, has examined data from its members to assess differences by industry on employer costs and lost-time durations in WC and STD. IBI found significant variation in WC costs across three industries, but much less variation in STD costs. WC costs also were higher in each of the three industries examined, compared to STD costs (Parry).
Ongoing NIOSH work using HPM data: A NIOSH feasibility surveillance project is under way that utilizes both HPM and CCE data from 2003-2005 to estimate rates and costs of pneumoconiosis and other work-related lung disease. Ongoing NIOSH work using group medical insurance claims data: NIOSH is currently developing a model for a new form of workplace health surveillance based on group medical insurance claims. A principal aim is to address the limitations of existing occupational surveillance systems in which only a small fraction of occupational disease cases is reported and results in WC claims. NIOSH is working with two major health insurers to calculate detailed disease rates by industry, thus helping to identify industries where workplace risk factors may be contributing significantly to health care costs. A wide variety of high priority diseases are included: asthma, COPD, pneumoconiosis, dermatitis, bladder cancer, carpal tunnel syndrome, low back pain, depression, Parkinsonism, hearing loss, hypertension, and others. Results will also be used by the health insurers to provide statistical reports to employers for targeting their health initiatives and to motivate the assessment and control of possible workplace factors. Results to date indicate that, for most diseases, several industries have significantly elevated rates and known occupational exposures that could be contributing to those rates (Fong et al, Tan-Torres et al, Hirsch et al).
MarketScan's HPM and CCE Databases will be used to assess the impact of worker injury and illness on employer costs, including absenteeism, WC, group medical insurance, and STD. The HPM Database contains data from large U.S. employers grouped by broad industrial sector. For 2005, the most recent year available, the database contains medical and pharmaceutical data on more than 1.6 million individuals, STD and WC data on more than 440,000 employees, and absence data on more than 190,000 employees. We will assess whether the industrial sectors differ in rates and costs of certain types of injuries and illnesses and, if so, whether high rates for a condition in WC correspond to high rates of the same condition under STD or medical claims. We can also determine the extent to which individuals with a certain injury or illness may receive care for the same condition or episode under WC, group medical insurance, and STD insurance. This will provide some evidence about the numbers of work-related cases being completely missed or only being partially paid by WC but contributing to the cost of the other programs.
The proposed HPM project will begin with the diagnostic categories based on ICD codes that were developed for the related ongoing NIOSH group medical insurance claims project (that does not use HPM data) described above, with more detailed disease, injury and condition categories to be added. Results of the two projects will be compared to assess differences and similarities in rates and costs, taking into consideration the differences of the databases used for each project. The related ongoing HPM feasibility project on lung disease described above also will provide insight on how to link and analyze the data for the proposed project.
In addition to the ongoing related projects described above, several NIOSH projects are currently being planned that will assess costs for specific diseases using HPM and other data sources (e.g. assessing the cost of stress, musculoskeletal disorders, and dermatitis). We will coordinate our efforts on the proposed HPM project with others in NIOSH who are or will be using HPM data, in order to avoid duplication and build on lessons learned. We also welcome additional NIOSH collaborators for the proposed HPM project. Collaboration and coordination with partners outside NIOSH will also be pursued to complement and enhance the utility of the proposed project.
Goetzel RZ, Long SR, Ozminkowski RJ, Hawkins K, Wang S, Lynch W. Health, Absence, Disability, and Presenteeism Cost Estimates of Certain Physical and Mental Health Conditions Affecting U.S. Employers. J Occup Environ Med. 2004;46: 398-412.
Parry T. Does Industry Make a Difference? Integrated Benefits Institute Research Insight, November 2007 (http://www.ibiweb.org/publications_research_insights.php).
Fong JK, Hirsch CW, O'Donnell G, Bushnell T. Research@Work: Supporting Employer Engagement in Health Promotion and Occupational Health Through Health Insurance Claims Analysis & Reporting. Presented at NIOSH WorkLife 2007: Protecting and Promoting Worker Health, A National Symposium, Bethesda, MD, September 11, 2007.
Tan-Torres S, Nash E, Reynolds LL, Bushnell T. Promoting Effective Worksite Wellness and Occupational Safety and Health. Poster presented at NIOSH WorkLife 2007: Protecting and Promoting Worker Health, A National Symposium, Bethesda, MD, September 10, 2007.
Hirsch WT, DeVries A, O'Donnell G, McAllister A, Bushnell T. Research@Work: An Innovative Public-Private Occupational Health Partnership. Poster presented at annual research meeting of AcademyHealth, June 25-27, 2006, Seattle, WA.
The findings and conclusions in this poster are those of the author(s) and do not necessarily represent the views of the National Institute for Occupational Safety and Health. Citations to Web sites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these Web sites.
View Comments on this Poster