To describe characteristics of industrial injury hospitalizations, and to test the hypothesis that industrial injuries were increasingly billed to non‐workers' compensation () payers over time.
Hospitalization data for 1998–2009 from State Inpatient Databases, Healthcare Cost and Utilization Project, and Agency for Healthcare Research and Quality.
Retrospective secondary analyses described the distribution of payer, age, gender, race/ethnicity, and injury severity for injuries identified using industrial place of occurrence codes. Logistic regression models estimated trends in expected payer.
There was a significant increase over time in the odds of an industrial injury not being billed to in California and Colorado, but a significant decrease in New York. These states had markedly different policy histories. Industrial injuries among older workers were more often billed to a non‐ payer, primarily Medicare.
Findings suggest potentially dramatic cost shifting from to Medicare. This study adds to limited, but mounting evidence that, in at least some states, the burden on non‐ payers to cover health care for industrial injuries is growing, even while ‐related employer costs are decreasing—an area that warrants further research.