HEALTH-CARE AND INDEMNITY COSTS ACROSS THE NATURAL-HISTORY OF DISABILITY IN OCCUPATIONAL LOW-BACK-PAIN

Study Design. The administrative database maintained by the National C ouncil on Compensation Insurance (United States) was used to compare h ealth care use and indemnity costs within the natural history of work- related low back pain disability. Objectives. To determine the relativ e costs of health care services and indemnity at different phases of w ork disability. Summary of Background Data. Existing studies have comp ared total costs along the work disability continuum. This study repli cates and extends these earlier studies by providing detailed evaluati ons of costs by service categories along this continuum. Methods. Tota l health care and indemnity costs accrued along the disability curve w ere examined. based on the number of days workers were absent from wor k and receiving indemnity payments (disability days), detailed mean he alth care costs by type of medial service were computed and compared a cross four time intervals for the sample. Results. Health care costs w ere disproportionately distributed along the disability curve, with 20 % of claimants disabled 4 months or more, accounting for 60% of health care costs. The most costly service category was diagnostic procedure s (25% of total medical costs), with surgical costs (21%) and physical therapy (20%) representing the next two most costly categories. Menta l health and chiropractic care represented a small percentage of overa ll costs (0.4% and 2.9%, respectively). Conclusions. These data provid e policy-makers, program development, and health care industry groups with cost information from which to establish benchmarks for future de cisions that facilitate the allocation of resources for more cost-effe ctive management and prevention of work disability.