Workers' Compensation “Reforms,” Choice of Medical Care Provider, and Reported Workplace Injuries

Boden, Leslie I.; Ruser, John W.

doi:10.1162/003465303772815826

Cited by 48 publications

(38 citation statements)

References 4 publications

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“…One reason is that many injured workers are treated by specialists, such as orthopedic surgeons and occupational medi- [1][2][3] Worker and advocacy groups have expressed concerns about this trend, believing that it detracts from effective coordination and continuity of care, and could jeopardize the quality of care by directing patients to physicians who will inappropriately limit patient services in response to employer and insurer interests. [7][8][9] Our study' s fi ndings may be relevant in this regard.…”

Section: Discussionmentioning

confidence: 99%

“…1 Recently, many states have given employers and insurers greater control over the choice of physician, in hopes of improving care and reducing workers' compensation costs. 2,3 Partly as a result, patients receiving primary care for a work-related condition often are not treated by their regular doctor. Only one quarter (25.6%) of visits for care of work-related conditions are provided by the patient' s regular primary care physician, compared with 51.2% among patients being treated for nonoccupational conditions.…”

Section: Introductionmentioning

confidence: 99%

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Services Provided by Family Physicians for Patients With Occupational Injuries and Illnesses

Won

Dembe²

2006

The Annals of Family Medicine

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PURPOSE Many family doctors provide care to patients with occupational injuries and illnesses, but little is known about the type of medical services provided, or how they compare with services provided by other types of physicians. This study used national data to develop a statistical profi le of offi ce-based medical care delivered by family physicians to patients with work-related disorders.METHODS Using data from 4 years (1997)(1998)(1999)(2000) of the National Ambulatory Medical Care Survey, we classifi ed visits for patients with work-related conditions according to patient and physician characteristics, services provided, and other visit characteristics. For comparison, we also compiled profi les for visits to other types of physicians for treatment of work-related disorders, and for visits to family physicians for treatment of nonoccupational conditions. RESULTS Analyses were based on 96,183 offi ce visits made to 4,947 physicians. A majority of visits made to family physicians for occupational conditions involved patients seeing their regular primary care doctor. Possibly for this reason, patients at these visits were more likely to have their blood pressure taken, receive diagnostic and screening services, and have prescription drugs prescribed or administered, compared with patients seeing other types of physicians. Only 73.3% of visits to family physicians for work-related disorders were expected to be paid for by workers' compensation insurance.CONCLUSIONS Our fi ndings suggest that the distinctive types of care provided by family physicians to injured workers may be related to their role as the patients' regular physician. This fi nding is relevant to the proposals being considered by many states to expand employers' and insurers' ability to choose the treating physician in workers' compensation cases. Ann Fam Med 2006;4:138-147. DOI: 10.1370/afm.515. INTRODUCTIONM edical care for patients with work-related injuries and illnesses in the United States is generally governed by state workers' compensation laws. In about one half of the states, injured employees are free to choose their initial treating physician.1 Recently, many states have given employers and insurers greater control over the choice of physician, in hopes of improving care and reducing workers' compensation costs. 2,3 Partly as a result, patients receiving primary care for a work-related condition often are not treated by their regular doctor. Only one quarter (25.6%) of visits for care of work-related conditions are provided by the patient' s regular primary care physician, compared with 51.2% among patients being treated for nonoccupational conditions. 4 Family physicians traditionally have played an important role in providing care for patients with occupational disorders, nevertheless. Approximately 22.9% of offi ce visits for care of work-related conditions are provided by family physicians. 139 OCCUPATIONAL INJURIES AND ILLNESSESLittle is known about the specifi c services that family physicians provide to patients wi...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Services Provided by Family Physicians for Patients With Occupational Injuries and Illnesses

Won

Dembe²

2006

The Annals of Family Medicine

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“…Boden and Ruser (2003) argue that workers' compensation reforms that made filing for workers' compensation more difficult suppressed the reporting of injuries, while Barkume and Ruser (2001) contend that deregulation of workers' compensation increased safety. Conway and Svenson 78 Hunt and Dillender (1998) argue that workers' compensation reforms decreased injury rates and that unions, employers, and workers' compensation insurers have developed a better understanding of workplace hazards.…”

Section: Trends In Work-related Injuriesmentioning

confidence: 99%

“…The 1979 National Longitudinal Survey of Youth has the appealing advantage of following individuals over time, meaning compositional changes to the labor force cannot drive the effects. Boden and Ruser (2003) study those states that restricted provider choice as well as states that began requiring objective evidence for workers' compensation claims using BLS establishment-level data. They compare how injury rates changed over time in states that modified their laws compared to how injury rates changed over time in states that did not modify their laws.…”

Section: Effects Of Other Aspects Of Workers' Compensation On Safetymentioning

confidence: 99%

Workers' Compensation: Analysis for Its Second Century

Hunt¹,

Dillender²

2017

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“…This mean rate of growth was nearly time-invariant for many decades before it started to drift down in the 1990s and stabilized at a new, lower level at around the year 2000. According to Boden and Ruser (2003), cost containment reforms (enacted in the early 1990s in many U.S. states) were a major factor behind the drop in frequency growth during the 1990s.…”

Section: Time Series Modeling Of the Manufacturing Industrymentioning

confidence: 99%

Workplace Injuries and Job Flows

Schmid¹

2009

SSRN Journal

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The growth rates of workplace injury and illness rates exhibit a negative (time varying) mean and a pro cyclical response to variations in economic activity, as they decline in recessions before rebounding (and overshooting) during economic recoveries. Using a structural time series model, it is shown that this business cycle behavior is driven by job flows. In recessions, the acceleration of job destruction increases the growth rate of workplace injury and illness incidence rate (which is indicative of moral hazard), while the slowdown in job creation depresses this growth rate by reducing the proportion of workers of short job tenure. AbstractThe growth rates of workplace injury and illness rates exhibit a negative (time-varying) mean and a pro-cyclical response to variations in economic activity, as they decline in recessions before rebounding (and overshooting) during economic recoveries. Using a structural time series model, it is shown that this business cycle behavior is driven by job flows. In recessions, the acceleration of job destruction increases the growth rate of workplace injury and illness incidence rate (which is indicative of moral hazard), while the slowdown in job creation depresses this growth rate by reducing the proportion of workers of short job tenure.

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Workers' Compensation “Reforms,” Choice of Medical Care Provider, and Reported Workplace Injuries

Cited by 48 publications

References 4 publications

Services Provided by Family Physicians for Patients With Occupational Injuries and Illnesses

Services Provided by Family Physicians for Patients With Occupational Injuries and Illnesses

Workers' Compensation: Analysis for Its Second Century

Workplace Injuries and Job Flows

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