title: Health risk factors as predictors of workers' compensation claim occurrence and cost.
abstract: The objective of this study was to examine the predictive relationships between employee health risk factors (HRFs) and workers' compensation (WC) claim occurrence and costs.
  
  
  
  Logistic regression and generalised linear models were used to estimate the predictive association between HRFs and claim occurrence and cost among a cohort of 16 926 employees from 314 large, medium and small businesses across multiple industries. First, unadjusted (HRFs only) models were estimated, and second, adjusted (HRFs plus demographic and work organisation variables) were estimated.
  
  
  
  Unadjusted models demonstrated that several HRFs were predictive of WC claim occurrence and cost. After adjusting for demographic and work organisation differences between employees, many of the relationships previously established did not achieve statistical significance. Stress was the only HRF to display a consistent relationship with claim occurrence, though the type of stress mattered. Stress at work was marginally predictive of a higher odds of incurring a WC claim (p<0.10). Stress at home and stress over finances were predictive of higher and lower costs of claims, respectively (p<0.05).
  
  
  
  The unadjusted model results indicate that HRFs are predictive of future WC claims. However, the disparate findings between unadjusted and adjusted models indicate that future research is needed to examine the multilevel relationship between employee demographics, organisational factors, HRFs and WC claims.
authors.affiliation: Department of Environmental and Occupational Health, Center for Health, Work, and Environment and Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA.
authors.forename: Natalie V
authors.initials: NV
authors.lastname: Schwatka
authors.affiliation: Department of Health Systems, Management & Policy, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Atherly
authors.affiliation: Department of Environmental and Occupational Health, Center for Health, Work, and Environment and Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA.
authors.forename: Miranda J
authors.initials: MJ
authors.lastname: Dally
authors.affiliation: China Center for Health Development Studies, Peking University, Beijing, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Fang
authors.affiliation: Segue Consulting, Denver, Colorado, USA.
authors.forename: Claire
authors.initials: C
authors.lastname: vS Brockbank
authors.affiliation: Department of Environmental and Occupational Health, Center for Health, Work, and Environment and Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA.
authors.forename: Liliana
authors.initials: L
authors.lastname: Tenney
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Institute for Health and Productivity Studies, and Truven Health Analytics, Bethesda, Maryland, USA.
authors.forename: Ron Z
authors.initials: RZ
authors.lastname: Goetzel
authors.affiliation: Integrated Benefits Institute, San Francisco, California, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Jinnett
authors.affiliation: Department of Environmental and Occupational Health, Center for Health, Work, and Environment and Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA.
authors.forename: Roxana
authors.initials: R
authors.lastname: Witter
authors.affiliation: Department of Environmental and Radiological Health Sciences, School of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Reynolds
authors.affiliation: Pinnacol Assurance, Denver, Colorado, USA.
authors.forename: James
authors.initials: J
authors.lastname: McMillen
authors.affiliation: Department of Environmental and Occupational Health, Center for Health, Work, and Environment and Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA.|Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA.|Department of Medicine, School of Medicine, University of Colorado, Aurora, Colorado, USA.
authors.forename: Lee S
authors.initials: LS
authors.lastname: Newman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007221:Industry; D007344:Insurance Claim Reporting; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D060051:Occupational Injuries / Q000191:economics* / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014942:Workers' Compensation / Q000191:economics* / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Health risk assessment; Occupational injury; Small business; Total Worker Health; Worksite wellness