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Trends in the Health Care Use and Expenditures Associated With No-Lost-Time Claims in Ontario: 1991 to 2006

Smith, Peter PhD; Chen, Cynthia MSc; Hogg-Johnson, Sheilah PhD; Mustard, Cameron ScD; Tompa, Emile PhD

Journal of Occupational and Environmental Medicine: February 2011 - Volume 53 - Issue 2 - p 211–217
doi: 10.1097/JOM.0b013e31820a416f
Original Articles

Objective: To examine trends in health care usage and expenditures associated with no-lost-time claims in Ontario over a 15-year period.

Methods: A secondary analysis of administrative workers’ compensation claims occurring between 1991 and 2006 (N = 2,290,101). We used regression analysis to model health care expenditures using a zero-inflated linear model, adjusting for age, gender, industry group and size of payroll.

Results: The probability of using health care increased over the time period. Health care expenditures per claim declined between 1991 and 1997, but then increased between 1998 and 2006, coinciding with the introduction of occupational health and safety legislation promoting early return to work in Ontario.

Conclusions: Our results provide support to the hypothesis that the increasing use of workplace accommodation since 1998 is a driver of the relatively stable rate of no-lost-time claims in Ontario.

From the Institute for Work & Health (Drs Smith, Hogg-Johnson, Mustard, and Tompa and Ms Chen) and Dalla Lana School of Public Health, University of Toronto (Drs Smith, Hogg-Johnson, Mustard, and Tompa), Toronto; and Department of Economics (Dr Tompa), McMaster University, Hamilton, Ontario, Canada.

This study was supported by a grant from the Ontario Workplace Safety and Insurance Board Research Advisory Council (07016). P.S. is supported by a New Investigator Award from the Canadian Institutes of Health Research.

Address correspondence to: Peter Smith, PhD, Institute for Work & Health, 481 University Ave, Ste 800, Toronto, ON M5G 2E9, Canada; E-mail:

©2011The American College of Occupational and Environmental Medicine