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Context: The Certified Safe Farm (CSF) intervention program aims to reduce occupational injuries and illnesses, and promote wellness to reduce health care and related costs to farmers, insurers, and other stakeholders. Purpose: To evaluate the cost effectiveness of CSF. Methods: Farms (316) located in a 9-county area of northwestern Iowa were recruited and randomized into intervention and control cohorts. Intervention farms received occupational health screenings, health and wellness screening, education, on-farm safety reviews, and performance incentives. For both cohorts, quarterly calls over 3 years were used to collect self-reported occupational injury and illness information, including costs to the farmers and their insurers. Findings: Annual occupational injury and illness costs per farmer paid by insurers were 45% lower in the intervention cohort ($183) than in the control cohort ($332). Although out-of-pocket expenses were similar for both cohorts, combined costs of insurance and out-of-pocket expenses were 27% lower in the intervention cohort ($374/year per farmer) compared to the control cohort ($512/year per farmer). Within the cohort of intervention farmers, annual occupational injury and illness cost savings were directly associated with on-farm safety review scores. Reported health care costs were $237 per farmer in the safest farms (those farms scoring in the highest tertile) versus $485 per farmer in the least safe farms (lowest tertile). Conclusions: Results suggest that farmers receiving the intervention had lower health care costs for occupational injuries and illnesses than control farmers. These cost savings more than cover the cost of providing CSF services (about $100 per farm per year).

Focuses on the assessment of injury characteristics and risk factors in the Iowa Certified Farm (CSF) program. Evaluation of the effectiveness of CSF for reducing injuries; List of risk factors contributing to agricultural injury; Impact of fatigue or stress on increasing injuries.

Data is presented on the health insurance coverage of approximately 260 farmers in Northwest Iowa. A combination of telephone interview and self-administered questionnaire was used to collect information on health insurance premiums, coinsurance rates, and deductibles. Data was also collected on the injury and illness experiences of the subjects. Thirty-nine percent (100) of primary farm operators and 63.5% (154) of spouses worked off the farm. Of those who worked off-farm, 30 primary operators (30%) had coverage through their off-farm employer, and 41 spouses (27%) received health insurance through their off-farm employer. In addition to a general description of demographics and insurance coverage, the following research questions were investigated: 1. Are farmers with high cost coverage less likely to seek health care when they have illnesses and injuries than are farmers who have low cost insurance coverage? 2. Do farmers with off farm employer coverage have lower insurance costs than farmers who have individual coverage? No conclusive evidence supported a relationship between the cost of coverage and the number of health care visits. However, persons with off-farm employer sponsored coverage had significantly lower premiums than those without off-farm coverage. Additionally, those with family coverage from an off-farm employer had significantly lower deductibles. Implications for use of health insurance premium reductions as an incentive for safe farms are also discussed. [ABSTRACT FROM AUTHOR]