Impact of Workplace Injury on Outpatient Prescription Opioid Use from Private Group Health Insurance

Details

• Personal Author:
  Asfaw A
• Description:
  Problem. Opioid misuse has been identified as a major public health problem in the United States. Despite research on the relationship among workplace injury, workers' compensation, and opioid use, little is known about the impact of workplace injury on prescription opioid use outside the workers' compensation system. Limiting the scope of opioid use by injured workers to the workers' compensation system likely underestimates the impact of workplace injury on opioid use because injured workers might use other sources to obtain opioid prescriptions. The objective of this study was to bridge this gap by examining the impact of workplace injury on opioid use from the employer-sponsored private group health insurance (GHI) system. Method. We used a difference-in-differences (DiD) method to examine the impact of workplace injury on the use of outpatient prescription opioids from the GHI two months before and two months after injury by injured workers compared with non-injured workers, the control group. Because dates of injury are not available for the non-injured workers, they were randomly assigned an index date or a 'pseudo injury date' (hereafter injury date) that corresponded to the date of injury of the pool of injured workers. We identified two outcome variables as proxies for outpatient prescription opioid use from the GHI: receiving one or more outpatient opioid prescriptions (hereafter opioid prescriptions) and total number of outpatient opioid prescriptions (hereafter number of opioid prescriptions). We also used logistic and negative binomial regression models for multivariate analysis. The data source for this study was the MarketScan database. We created a cohort of workers (ages 18 to 65 years) who were continuously enrolled both in the workers' compensation and GHI system from 2013 to 2015. The intervention event was incidence of a workplace injury that occurred between January 1st and December 31st 2014. We considered 19,246 workers who were injured only once in 2014 and not injured in 2013 and 2015. From the total of 759,942 workers who were not injured from 2013 to 2015, we randomly selected 96,230 non-injured workers - five times of the number of injured workers - as a control group. Overall, 115,476 workers were included in the study. We controlled for age, sex, health insurance type, hourly/salary status, and region in adjusted analyses. Results. The results show parallel trends were observed in all outcome variables across the injured and non-injured workers before injury. This indicates that in the absence of injury, the differences in opioid prescriptions between injured and non-injured workers were constant over time. Within two months before injury, 6.3% and 8.1% of non-injured and injured workers, respectively, received one or more opioid prescriptions. ... Conclusion. To our knowledge, this is the first study that examined the impact of workplace injury on opioid use from the GHI using a robust quasi-experimental framework. Among a cohort of workers with GHI, there were statistically significant differences in opioid use (percentage of workers and number of opioid prescriptions) from the GHI for injured workers compared to non-injured workers. Reducing workplace injury rates can have a significant impact on reducing the use of prescription opioids. [Description provided by NIOSH]
• Subjects:
  Biopharmaceutics Drug Therapy Occupational Health Safety
• Keywords:
  Drugs Drug Therapy Health Care Humans Injuries Injury Prevention Intervention Medical Treatment Outpatient Facilities Pharmaceuticals Statistical Analysis Workers Workers Compensation

  More +
• Publisher:
  American Psychological Association
• Document Type:
  Text
• Genre:
  Abstract or Summary
• Place as Subject:
  District of Columbia ; OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OD - Office of the Director
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  109-110
• NIOSHTIC Number:
  nn:20059072
• Citation:
  Work, Stress and Health 2019, November 6-9, 2019, Philadelphia, Pennsylvania. Washington, DC: American Psychological Association, 2019 Nov; :109-110
• Federal Fiscal Year:
  2020
• Peer Reviewed:
  False
• Source Full Name:
  Work, Stress and Health 2019, November 6-9, 2019, Philadelphia, Pennsylvania
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c72bc5a9dc1039182dadba94563ca7e9ffb6a327eaebf22d533f6841a5a69953753ddd7440a49498ad66342d4f2b5671e3165eb3e39164b2e521853a4599f94a
• Download URL:
  https://stacks.cdc.gov/view/cdc/223392/cdc_223392_DS1.pdf
• File Type:
  [PDF - 112.79 KB ]