Health care utilization for musculoskeletal back disorders, Washington State union carpenters, 1989-2003.
OBJECTIVE
Private health care utilization rates for musculoskeletal back disorders were contrasted to rates of work-related injuries or disorders for a large cohort of union carpenters over a 15-year period.


METHODS
Yearly utilization rates were compared with rates of work-related back injuries or disorders. Negative binomial regression with generalized estimating equations was used to assess utilization rates based on age, gender, union tenure, type of work, and previous work-related back injuries.


RESULTS
Private utilization rates were over twice as high in 2003 as in 1989 whereas compensation rates declined substantially. Utilization was higher among carpenters with less union tenure and increased with the number of work-related injuries.


CONCLUSIONS
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.
Department of Community and Family Medicine, Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, NC 27710, USA. Hester.lipscomb@duke.edu
Hester J
HJ
Lipscomb
John M
JM
Dement
Barbara
B
Silverstein
Kristen L
KL
Kucera
Wilfrid
W
Cameron
D000062:Accidents, Occupational; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D001415:Back; D019567:Back Injuries / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D001847:Bone Diseases / Q000191:economics* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005260:Female; D006264:Health Benefit Plans, Employee / Q000706:statistics & numerical data*; D006801:Humans; D007750:Labor Unions; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000191:economics* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D009784:Occupational Diseases / Q000191:economics* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D009790:Occupations; D012044:Regression Analysis; D014861:Washington / Q000453:epidemiology; D014942:Workers' Compensation / Q000706:statistics & numerical data; D055815:Young Adult