title: Medical expenditures associated with nonfatal occupational injuries among U.S. workers reporting persistent disabilities.
abstract: BACKGROUND
  No prior study has investigated the medical expenditures associated with occupational injuries among U.S. workers with persistent disabilities, including those with physical disabilities or cognitive limitations.
  
  
  OBJECTIVE
  Using the 2004-2011 Medical Expenditure Panel Survey (MEPS) data (Panels 9-15), we estimated the 2-year incidence and the expenditures associated with occupational injuries in U.S. workers with and without persistent disabilities.
  
  
  METHODS
  Expenditures were compared by type of service and sources of payment. We estimated the mean medical expenditures using linear regression analysis to adjust for sociodemographics. The statistical analysis accounted for the sample survey design of MEPS and the highly skewed expenditure data.
  
  
  RESULTS
  The 2-year cumulative incidence of occupational injuries was 13.6% (95% CI: 11.6%-15.6%) in workers with persistent disabilities and 7.1% (95% CI: 6.8%-7.4%) in workers without persistent disabilities. The average medical expenditure associated with new occupational injuries in the 2-year follow-up period was $3778 in workers with disabilities, $2212 in workers without disabilities after adjusting for sociodemographics and medical insurance coverage status (in 2011 U.S. dollars, p-value = 0.0004). Of the total expenditures for occupational injuries, workers' compensation paid 54.6% in workers with disabilities and 58.9% in workers without disabilities. There was no significant difference in the proportion of injured workers with and without disabilities who reported receiving workers' compensation benefits (46.7% vs. 48.2%, p-value = 0.718).
  
  
  CONCLUSIONS
  Workers with persistent disabilities had a significantly higher incidence of occupational injuries and higher medical costs compared with workers without persistent disabilities. Many questions with regard to occupational safety and worker's compensation benefits in workers with disabilities remain unexplored.
authors.affiliation: Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, USA.
authors.forename: Junxin
authors.initials: J
authors.lastname: Shi
authors.affiliation: Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, USA.
authors.forename: Krista K
authors.initials: KK
authors.lastname: Wheeler
authors.affiliation: College of Public Health, Division of Biostatistics, The Ohio State University, USA.
authors.forename: Bo
authors.initials: B
authors.lastname: Lu
authors.affiliation: Injury Research and Policy, Johns Hopkins Center for International Injury Research Unit, Johns Hopkins University, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Bishai
authors.affiliation: Colorado Injury Control Research Center, Colorado State University, USA.
authors.forename: Lorann
authors.initials: L
authors.lastname: Stallones
authors.affiliation: Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, USA; Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, USA; The Ohio State University College of Medicine, USA. Electronic address: Huiyun.Xiang@NationwideChildrens.org.
authors.forename: Huiyun
authors.initials: H
authors.lastname: Xiang
mesh_terms: D000293:Adolescent; D000328:Adult; D006233:Persons with Disabilities; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000191:economics* / Q000453:epidemiology; D060051:Occupational Injuries / Q000191:economics* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014942:Workers' Compensation; D055815:Young Adult
keywords: Activity limitations; Disability; Functional limitations; Health care expenditure; Occupational injury