Emergency room visits by injured workers showed “substantial variation” across 28 states, even for the same injuries, calling into question whether some state programs push the more expensive care at the start of an injury regardless of medical necessity, according to a report released Monday by the Workers Compensation Research Institute.
In 2021, ED utilization for initial medical services ranged from 14% in Arizona to 37% in Massachusetts, with many states falling in the 20% to 25% range. WCRI found that the variation was even greater for conditions such as sprains and strains.
Some factors behind the variation “may include local standards for use of emergency rooms and state functions of workers̵7; compensation systems,” WCRI said.
The pandemic also played a role: The study found that between 2020 and 2021, emergency room use for first medical services tended to be lower when the number of Covid-19 cases was higher.
“The significant interstate variation in the use of (emergency departments) between states, even for the same type of injury, raises questions about why we observe this variation and whether it comes from the design of workers’ compensation systems or other factors,” said John Ruser, president and CEO of WCRI, in a statement.
The states included in the study represent 79% of workers’ compensation payments made in the United States, according to WCRI.