Collider Bias in Administrative Workers' Compensation Claims Data: A Challenge for Cross-Jurisdictional Research.

Journal of Occupational Rehabilitation
Tyler J Lane

Abstract

Workers' compensation claims consist of occupational injuries severe enough to meet a compensability threshold. Theoretically, systems with higher thresholds should have fewer claims but greater average severity. For research that relies on claims data, particularly cross-jurisdictional comparisons of compensation systems, this results in collider bias that can lead to spurious associations confounding analyses. In this study, I use real and simulated claims data to demonstrate collider bias and problems with methods used to account for it. Using Australian claims data, I used a linear regression to test the association between claim rate and mean disability durations across Statistical Areas. Analyses were repeated with nesting by state/territory to account for variations in compensability thresholds across compensation systems. Both analyses are repeated on left-censored data. Simulated claims data are analysed with Cox survival analyses to illustrate how left-censoring can reverse effects. The claim rate within a Statistical Area was inversely associated with disability duration. However, this reversed when Statistical Areas were nested by state/territory. Left-censoring resulted in an attenuation of the unnested association...Continue Reading

References

Mar 30, 2000·Journal of Occupational and Environmental Medicine·L K DasingerL Rudolph
Apr 9, 2004·International Journal of Occupational and Environmental Health·Michael B LaxRosemary A Klein
Jul 19, 2008·Journal of Occupational Rehabilitation·Jeanne M Sears, Patrick J Heagerty
Apr 2, 2011·International Journal of Epidemiology·Miguel A HernánNiels Keiding
Jan 25, 2012·American Journal of Industrial Medicine·Emily A Spieler, John F Burton
May 30, 2014·Journal of Occupational Rehabilitation·Elizabeth KilgourAlex Collie
Oct 23, 2015·Journal of Occupational and Environmental Medicine·Mujahed ShraimGlenn Pransky
Dec 24, 2015·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Catherine Pollak
Jul 10, 2018·BMJ Evidence-based Medicine·Steven D StovitzJay S Kaufman
Jul 1, 2014·Annual Review of Sociology·Felix Elwert, Christopher Winship
Mar 30, 2020·Occupational and Environmental Medicine·Tyler J LaneAlex Collie

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