Academic journal article Bulletin of the World Health Organization

Cost of Work-Related Injuries in Insured Workplaces in Lebanon

Academic journal article Bulletin of the World Health Organization

Cost of Work-Related Injuries in Insured Workplaces in Lebanon

Article excerpt

Voir page 514 le resume en francais. En la pagina 515 figura un resumen en espanol.

Introduction

The economic burden of work-related injuries is a useful tool to convince workers and employers of the cost-benefit of work safety and the effectiveness of preventative interventions. It also guides employers and policy-makers on how to allocate resources effectively (1, 2). Takala reported a higher incidence of fatal work-related injuries in developing countries than in established market economies (11-23 vs 5.4 per 100 000 workers, respectively) (3). Such injuries produce a major economic and social burden in developed and developing countries (2-10).

Lebanon--a small Arab country with an area of 10 452 [km.sup.2], a population of 4 million, and a service-oriented economy--had a GDP of US$ 16.7 billion in 2001 (11). The 15-year civil war (1975-90) and regional instability have resulted in an ongoing challenge to the Lebanese economy, which has an unemployment rate of [greater than or equal to] 14% (12). Occupational health and safety in Lebanon has been given little significance, surveillance systems for occupational injury were never established, and an unknown but low proportion of employers insured their workplaces and workers against accidents (13).

The Lebanese workers' compensation law requires employers to provide workers injured at work with full medical care, 75% of their daily salary starting from the day of the injury, and compensation for permanent disabilities and death. Some employers purchase work-accident insurance policies from private insurance companies, but most employers elect to pay out-of-pocket at the time of injury. Insurance policies are issued for the worksite as a whole, not in the name of individual workers.

These facts have limited the opportunity to examine the magnitude of work-related injuries at a national level and might explain the absolute absence of studies on the topic. This study aimed to outline the magnitude of the problem and identify areas for potential research and interventions. Specifically, we estimate the overall cost of work-related injuries in insured workplaces in Lebanon and examine cost distribution by worker and injury characteristics.

Methods

Study population

The target population was workers employed in all insured workplaces in Lebanon in 1998. The attainable population was those employed in workplaces insured by 11 private insurance companies whose portfolios were managed by MedNet-Liban--a third-party administrator. These insurance companies represented approximately 30% of the market for work-related injury insurance in 1998 (14). MedNet-Liban processed the claims of injured workers who presented for medical care in participating hospitals. A pre-authorization "visa form" was issued for each visit, and one or more visa forms could be issued for a single injury. MedNet-Liban computerized selected information from these forms and sent the original hard copies to the insurance companies.

Study sample

In 1998, MedNet-Liban issued 8432 work-related injury visa forms for the 11 insurance companies. At the time of the audit, six companies were excluded: three had each processed less than 30 forms annually, one was out of business, and two refused to participate. The five participating companies were responsible for 7329 out of the total 8432 visa forms (86.9%). Of these, 4186 (57.1%) forms, which corresponded to 3748 cases of injury, were available for review. The remaining 3143 forms were not accessible for a variety of administrative reasons.

Data collection and management

Raw unprocessed data (age, sex, industry type, occupation, income, and "injury event narrative") were extracted from the insurance claims and the related medical and financial reports. Claims were grouped into four categories according to age (10-19, 20-29, 30-39, and [greater than or equal to] 40 years). …

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