Medical expenditures associated with nonfatal occupational injuries among immigrant and U.S.-born workers.
BACKGROUND
No national study has investigated whether immigrant workers are less likely than U.S.-workers to seek medical treatment after occupational injuries and whether the payment source differs between two groups.


METHODS
Using the 2004-2009 Medical Expenditure Panel Survey (MEPS) data, we estimated the annual incidence rate of nonfatal occupational injuries per 100 workers. Logistic regression models were fitted to test whether injured immigrant workers were less likely than U.S.-born workers to seek professional medical treatment after occupational injuries. We also estimated the average mean medical expenditures per injured worker during the 2 year MEPS reference period using linear regression analysis, adjusting for gender, age, race, marital status, education, poverty level, and insurance. Types of service and sources of payment were compared between U.S.-born and immigrant workers.


RESULTS
A total of 1,909 injured U.S.-born workers reported 2,176 occupational injury events and 508 injured immigrant workers reported 560 occupational injury events. The annual nonfatal incidence rate per 100 workers was 4.0% (95% CI: 3.8%-4.3%) for U.S.-born workers and 3.0% (95% CI: 2.6%-3.3%) for immigrant workers. Medical treatment was sought after 77.3% (95% CI: 75.1%-79.4%) of the occupational injuries suffered by U.S.-born workers and 75.6% (95% CI: 69.8%-80.7%) of the occupational injuries suffered by immigrant workers. The average medical expenditure per injured worker in the 2 year MEPS reference period was $2357 for the U.S.-born workers and $2,351 for immigrant workers (in 2009 U.S. dollars, P = 0.99). Workers' compensation paid 57.0% (95% CI: 49.4%-63.6%) of the total expenditures for U.S.-born workers and 43.2% (95% CI: 33.0%-53.7%) for immigrant workers. U.S.-born workers paid 6.7% (95% CI: 5.5%-8.3%) and immigrant workers paid 7.1% (95% CI: 5.2%-9.6%) out-of-pocket.


CONCLUSIONS
Immigrant workers had a statistically significant lower incidence rate of nonfatal occupational injuries than U.S.-born workers. There was no significant difference in seeking medical treatment and in the mean expenditures per injured worker between the two groups. The proportion of total expenditures paid by workers' compensation was smaller (marginally significant) for immigrant workers than for U.S.-born workers.
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, College of Medicine, The Ohio State University, 700 Children's Drive, Columbus, OH 43205, USA. huiyun.xiang@nationwidechildrens.org
Huiyun
H
Xiang
Junxin
J
Shi
Bo
B
Lu
Krista
K
Wheeler
Weiyan
W
Zhao
J R
JR
Wilkins
Gary A
GA
Smith
D000293:Adolescent; D000328:Adult; D016001:Confidence Intervals; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics; D017048:Health Care Costs / Q000145:classification / Q000639:trends*; D019538:Health Care Surveys; D005102:Health Expenditures / Q000145:classification / Q000639:trends*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D060051:Occupational Injuries / Q000191:economics* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult