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Health care utilization of carpenters with substance abuse‐related diagnoses
Author(s) -
Lipscomb Hester J.,
Dement John M.,
Li Leiming
Publication year - 2003
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.10170
Subject(s) - medicine , substance abuse , health care , workforce , occupational safety and health , workers' compensation , ambulatory care , poison control , injury prevention , alcohol abuse , psychiatry , environmental health , medical emergency , family medicine , compensation (psychology) , psychology , pathology , psychoanalysis , economics , economic growth
Background Persons in the construction trades in the US have high rates of alcohol and substance abuse. We had the unique opportunity to evaluate health care utilization through private insurance and workers' compensation for a group of carpenters at high risk of injury and substance abuse. Methods We identified a cohort of union carpenters. Their claims for medical care through union insurance and workers' compensation, and appropriate measures of time at risk were documented. Using methods of indirect standardization, we compared utilization and costs between carpenters with and without alcohol and substance‐abuse related diagnoses (ASRD). Results Through private insurance, those with ASRD had 10% higher outpatient utilization and 2.1 times higher rates of hospitalizations for injury care; 2.6 times higher rates of outpatient care; and 2.9 times higher inpatient admissions for non‐injury care. Individuals with ASRD had only modestly increased rates (10%) of outpatient utilization through workers' compensation. Conclusions These findings support the need for alcohol and drug abuse prevention and treatment services for this workforce. Operationalizing this among highly mobile workforces, such as the construction trades, is a challenge. While not intending to minimize the problems of alcohol or substance abuse on the job among carpenters, the focus of prevention should not necessarily be in the workplace. Am. J. Ind. Med. 43: 120–131, 2003. © 2003 Wiley‐Liss, Inc.