title: Industrial Injury Hospitalizations Billed to Payers Other Than Workers' Compensation: Characteristics and Trends by State.
abstract: To describe characteristics of industrial injury hospitalizations, and to test the hypothesis that industrial injuries were increasingly billed to non-workers' compensation (WC) payers over time.
  
  
  
  Hospitalization data for 1998-2009 from State Inpatient Databases, Healthcare Cost and Utilization Project, and Agency for Healthcare Research and Quality.
  
  
  
  Retrospective secondary analyses described the distribution of payer, age, gender, race/ethnicity, and injury severity for injuries identified using industrial place of occurrence codes. Logistic regression models estimated trends in expected payer.
  
  
  
  There was a significant increase over time in the odds of an industrial injury not being billed to WC in California and Colorado, but a significant decrease in New York. These states had markedly different WC policy histories. Industrial injuries among older workers were more often billed to a non-WC payer, primarily Medicare.
  
  
  
  Findings suggest potentially dramatic cost shifting from WC to Medicare. This study adds to limited, but mounting evidence that, in at least some states, the burden on non-WC payers to cover health care for industrial injuries is growing, even while WC-related employer costs are decreasing-an area that warrants further research.
authors.affiliation: Department of Health Services, University of Washington, Seattle, WA.|Harborview Injury Prevention and Research Center, Seattle, WA.|Institute for Work and Health, Toronto, ON, Canada.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Sears
authors.affiliation: Department of Health Policy and Management, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Bowman
authors.affiliation: Department of Health Services, University of Washington, Seattle, WA.|Harborview Injury Prevention and Research Center, Seattle, WA.
authors.forename: Laura
authors.initials: L
authors.lastname: Blanar
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Sheilah
authors.initials: S
authors.lastname: Hogg-Johnson
mesh_terms: D000062:Accidents, Occupational / Q000191:economics* / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D012051:Reimbursement Mechanisms / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States; D014942:Workers' Compensation / Q000191:economics* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Workers' compensation; cost shifting; hospital discharge data; insurance coverage; occupational injuries