Who is paying the bills? Health care costs for musculoskeletal back disorders, Washington State Union Carpenters, 1989-2003.

Journal Article (Journal Article)

OBJECTIVE: Factors associated with private health insurance payment rates for musculoskeletal back disorders were examined among a 15-year cohort of union carpenters. Payment patterns were contrasted with work-related back injury rates over time. METHODS: Negative binomial regression was used to assess payment rates; generalized estimated equations accounted for multiple observations per person and cost correlation within subjects. RESULTS: Payment rates increased after work-related injury and with the number of injuries. Increasing private payments and deductibles (inflation-adjusted and discounted) were observed in contrast with a marked decline in reported work-related injuries. CONCLUSIONS: Private insurance payments do not appear to be independent of work-related back injury. Findings suggest cost-shifting from workers' compensation to the union-provided health insurance and to the worker; they also provide a warning regarding reliance on workers' compensation statistics for surveillance of work-related disorders or disease.

Full Text

Duke Authors

Cited Authors

  • Lipscomb, HJ; Dement, JM; Silverstein, B; Cameron, W; Glazner, JE

Published Date

  • October 2009

Published In

Volume / Issue

  • 51 / 10

Start / End Page

  • 1185 - 1192

PubMed ID

  • 19749603

Electronic International Standard Serial Number (EISSN)

  • 1536-5948

Digital Object Identifier (DOI)

  • 10.1097/JOM.0b013e3181b68d0a


  • eng

Conference Location

  • United States