使用功能性并发症指数与行政工作者的薪酬数据:实用性,有效性和警告
Jeanne M Sears1,2,3, Sean D Rundell1,4,5, Deborah Fulton-Kehoe2
1Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA.
American journal of industrial medicine
|November 20, 2023
概括
从工人赔偿 (WC) 数据中得出的功能性并发症指数 (FCI) 显示了识别慢性疾病和预测工作结果的敏感性较低. 基于WC的FCI的跨州使用可能会引入混,需要谨慎和州特定的验证.
科学领域:
- 职业健康 职业健康 职业健康
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 慢性健康状况显著影响工人的结果,但很难使用行政工人赔偿 (WC) 数据来量化.
- 功能性并发症指数 (FCI) 是为了预测社区环境中的功能性结果而建立的,但需要在WC群体内进行验证.
- 评估WC衍生FCI用于识别慢性疾病和预测与工作相关的结果,对于改善工人健康管理至关重要.
研究的目的:
- 验证基于工人赔偿 (WC) 的功能性并发症指数 (FCI),用于识别受伤工人的慢性疾病.
- 评估基于WC的FCI对关键工作相关结果的预测有效性.
- 评估基于WC的FCI在多州研究中控制混的实用性.
主要方法:
- 将行政WC数据与俄俄州和华盛顿州受伤工人的前性调查数据联系起来.
- 在受伤后6周和6个月收集的调查数据,使用调查衍生FCI作为参考标准.
- 使用6个月的工作相关结果评估预测有效性和混控制.
主要成果:
- 基于WC的FCI表现出高特异性,但对于识别慢性疾病的敏感性较低,与工作结果的关联较弱.
- 基于调查的FCI表明俄俄州 (平均值=1.38) 与华盛顿州 (平均值=1.14) 的共发病率更高;基于WC的FCI显示相反 (俄俄州平均值=0.10 与华盛顿州平均值=0.33).
- 在多状态模型中取代基于WC的FCI将状态效应估计从零转移 (8.95%的变化),而不是基于调查的FCI (<1%的变化).
结论:
- 基于WC的FCI可以识别患有慢性疾病的特定工人子集,但对估计总体患病率效果不佳.
- 基于WC的FCI的跨州应用可以引入显著的混,可能会扭曲研究结果.
- 建议在多个州的研究中使用基于WC的FCI之前,使用可靠的参考标准进行特定州的验证.
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