The National Council on Compensation Insurance (NCCI) published a new report on demographic shifts and medical utilization within workers’ comp.
The report found that differences in medical utilization across demographic groups operate primarily through three key variables: diagnosed medical conditions, industry class, and treated comorbidities.
For instance, claims for workers aged 65 and older have doubled since 2012 and require 21% more care on average, primarily due to chronic health conditions and diagnoses, which impact older populations more than younger populations. The report states that if the distribution of comorbidities in older workers matched that of younger workers, the utilization gap would fall to 4%.
Workers aged 65+ had a 14.2% rate of hypertension, a 6.9% rate of diabetes, a 4.7% rate of blood vessel diseases, and a 28.6% rate of degenerative comorbidities, compared to rates of 6.3%, 3.2%, 1.3%, and 20.9% for the same conditions in workers aged 16-64.
The NCCI also noted that older workers are more likely to experience injuries associated with serious medical conditions that require more extensive treatment. Four medical conditions account for most of this effect, representing approximately one in five claims. Rotator cuff tears and hip or pelvis fractures are more common among older workers and are associated with higher utilization. By contrast, low back pain and minor ankle or foot injuries are more common among younger workers and generally require less treatment.
When reviewing data across gender, claims for male workers require 28% more care on average than claims for female workers, primarily due to industry mix and diagnosis types. The report notes that because male and female workers are often concentrated in distinct industries and frequently perform varying tasks within the same industry, they face different occupational hazards, resulting in different levels of injury intensity.
For instance, higher rates of male workers are in the construction, manufacturing, and transportation and warehousing industries, which often more serious injuries.
