CLAIMS BASED SURVILLANCE TO IDENTIFY INJURY PRECURSORS

该项目的目的是通过旨在开发具有成本效益的、具有广泛适用性的基于索赔的伤害和疾病监测系统的研究，改善工作场所的安全和健康。在这项提案中，我们将使用一个数据库和预期的记录链接系统，该系统是通过我们目前资助的NIOSH项目--工人补偿中的上缴支付分析--开发的，以创建一个工作场所监督计划。在具体目标一中，我们将制定程序和协议，将工人赔偿索赔数据转化为工伤和疾病监测系统。将生成按部门跟踪工作场所伤害和疾病事件的报告，并将其提供给雇主。在具体目标2中，我们将确定以索赔为基础的监测系统漏报工作场所伤害和疾病的程度。工人赔偿索赔数据库通常只包括严重到需要接受治疗的伤害的详细信息。通过监测系统确定的职业伤害率和疾病率和特征将与该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漏报的程度。在具体目标三中，我们将扩大使用基于索赔的数据，以开发和测试各种方法，以确定预测可通过初级预防行动解决的前兆事件的模式。我们会就这项研究所收集的医疗索偿数据，应用时间序列模型，探讨如何找出雇主可使用的工伤事件重要指标，以告知他们工作场所安全的变化。在具体目标四中，我们将制定雇主指南，以使用其工人补偿医疗索赔数据库进行监测活动。这将产生一个明确的产品，指导雇主将其工人赔偿索赔数据转化为可行、低成本和实用的监督计划。这项建议涉及国家职业研究议程(NARA)监视研究方法的优先研究领域，并通过满足NIOSH RFA OH-99-0-002的需求来回应NIOSH RFA OH-99-0-002的需要，即“调整保险业数据的使用的方法……以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."