title: The association between workers' compensation claims involving neck pain and future health care utilization: a population-based cohort study.
abstract: OBJECTIVE
  To describe the health care utilization of injured workers who made a workers' compensation claim for neck pain.
  
  
  METHODS
  We conducted a cohort study of injured workers who made an incident claim involving neck pain to the Ontario Workplace Safety and Insurance Board between 1997 and 1998. We linked their workers' compensation and Ontario Health Insurance Plan files to collect all health care services accrued during the year prior to and 2 years after the claim was initiated. We report the 7 day simple moving average of health care services per 1,000 claimants per day. We stratified our analysis by age, sex, the pre-claim level of health care utilization, diagnostic category and health care specialty.
  
  
  RESULTS
  58.1 % of claimants were males and 35.1 % were between the ages of 35 and 44 years. The cumulative rate of health care utilization was stable (mean = 60.80 services/1,000 claimants/day; 95 % CI: 59.7-62.0) throughout the year prior to the claim. However, it peaked during the first 4 days following the onset of the claim (mean = 473.3 services/1,000 claimants/day) and remained on average 311 % higher than baseline during the first month post-claim. On average in our sample, the health care utilization remained 11 % higher in the second year after the claim compared to the pre-claim level. This sustained increase was attributable to 6 % of claimants.
  
  
  CONCLUSIONS
  We report a long-term increase in the average number of health care services utilized by injured workers who make a workers' compensation claim involving neck pain. This increase was attributable to a minority of claimants. The health reasons for this increase deserve further investigation.
authors.affiliation: Faculty of Health Sciences, University of Ontario Institute of Technology, 2000 Simcoe Street North, Oshawa, ON, L1H 7K4, Canada, pierre.cote@uoit.ca.
authors.forename: Pierre
authors.initials: P
authors.lastname: Côté
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Yang
authors.forename: Vicki
authors.initials: V
authors.lastname: Kristman
authors.forename: Sheilah
authors.initials: S
authors.lastname: Hogg-Johnson
authors.forename: Dwayne
authors.initials: D
authors.lastname: Van Eerd
authors.forename: Mana
authors.initials: M
authors.lastname: Rezai
authors.forename: Marjan
authors.initials: M
authors.lastname: Vidmar
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005194:Family Practice / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D026882:Manipulation, Chiropractic / Q000706:statistics & numerical data; D008875:Middle Aged; D019547:Neck Pain / Q000534:rehabilitation* / Q000628:therapy; D009784:Occupational Diseases / Q000534:rehabilitation* / Q000628:therapy; D009864:Ontario; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data; D012737:Sex Factors; D013997:Time Factors; D014942:Workers' Compensation / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D055815:Young Adult