CLAIMS BASED SURVILLANCE TO IDENTIFY INJURY PRECURSORS

该项目的目的是通过研究改善工作场所的安全和健康，其目的是发展具有广泛适用性的具有成本效益的基于索赔的伤害和疾病监测系统。在本提案中，我们将使用一个数据库和前瞻性记录链接系统，该系统是通过我们目前资助的NIOSH项目“工人赔偿的资本化支付分析”开发的，以创建一个工作场所监控计划。在具体目标1中，我们将制定程序和协议，将工人赔偿索赔数据转化为与工作有关的伤害和疾病的监测系统。按部门跟踪工作场所伤害和疾病事件的报告将生成并提供给雇主。在具体目标II中，我们将确定基于索赔的监督系统少报工作场所伤害和疾病的程度。工人赔偿索赔数据库一般只包括需要医疗的严重伤害的详细信息。通过监测系统确定的职业伤害和疾病率和特征将与纽约市使用的更全面的雇员伤害报告进行比较，以评估基于索赔的系统少报的程度。在具体目标三中，我们将扩大使用基于索赔的数据来开发和测试方法，以确定预测可通过初级预防行动解决的前兆事件的模式。我们将运用时间序列模型对本研究收集的医疗理赔数据进行分析，探讨如何识别工伤事件的重要指标，以便雇主了解工作场所安全的变化。在具体目标四中，我们将制定雇主使用其工人赔偿医疗索赔数据库进行监测活动的准则。这将产生一个明确的产品，指导雇主将工人的赔偿索赔数据转化为可行、低成本和功能性的监督程序。该提案解决了国家职业研究议程（NORA）监测研究方法的优先研究领域，并通过解决“适应保险业数据使用的方法”的需求，响应NIOSH RFA OH-99-0-002。促进工作场所疾病和伤害的早期识别、报告和预防。”

The purpose of this project is to improve workplace safety and health through research aimed at developing a cost-effective claims-based injury and illness surveillance system which has broad applicability. In this proposal, we will use a database and prospective record linking system developed through our currently funded NIOSH project Analysis of Capitated Payment in Workers' Compensation to create a workplace surveillance program. In Specific Aim I, we will develop the procedures and protocols to transform Workers' Compensation Claims data into a surveillance system for work-related injuries and illnesses. Reports which track workplace injuries and illness events by department will be generated and provided to the employer. In Specific Aim II, we will determine the degree to which the claims-based surveillance system under-reports workplace injuries and illnesses. Workers' compensation claims databases generally include detailed information only on injuries sufficiently severe to require medical treatment. Occupational injury and illness rates and characteristics identified through the surveillance system will be compared with a more comprehensive Employee Injury Report used by the City, to assess the magnitude of under-reporting by the claims-based system. In Specific Aim III we will extend the use of claims-based data to develop and test methods to identify patterns which predict precursor events that could be addressed through primary prevention actions. We will apply time series models on medical claims data collected under this study to explore the issue of identifying important indicators of injury events usable by employers to inform them of changes in workplace safety. In Specific Aim IV, we will develop employer guidelines for using their workers' compensation medical claims databases for surveillance activities. This will result in an explicit product to guide employers in translating their workers' compensation claims data in to a feasible, low-cost and functional surveillance program. This proposal addresses the National Occupational Research Agenda (NORA) priority research area of Surveillance Research Methods and responds to the NIOSH RFA OH-99-0-002 by addressing the need for "Methods to adapt the use of insurance industry data ... to promote the early recognition, reporting, and prevention of workplace illness and injury."