The Cost of Hand Injuries to Non-United States Citizen Manual Laborers

Purpose Non-United States (US) citizen Spanish-speaking workers in high-risk manual labor occupations experience disproportionately high rates of work-related injuries. This study examined injury patterns, treatments, return-to-work status, and medical costs associated with work-related hand injuries in this population. Methods This retrospective study analyzed 3,878 patient charts from a level one trauma center in the Southeastern United States from 2016 to 2024, identifying 46 non-US citizen Spanish-speaking manual laborers with work-related hand injuries. Key variables included injury type, return-to-work status, total medical costs, and hospital length of stay. Results The cohort consisted of 45 men and 1 woman, most of whom (78.26%) were employed in construction-related roles. Insurance distribution was 50% free care, 34.78% self-pay, and 15.22% workers' compensation. Average cost per patient was highest in the free care group ($99,503.02 ± $121,740.74), followed by workers' compensation ($73,055.81 ± $63,818.97) and self-pay ($33,231.66 ± $32,925.58), with a total cost burden of $3,258,610.94. Conclusions This study highlights significant financial burdens and health care disparities faced by non-US citizen Spanish-speaking manual laborers with work-related hand injuries. Addressing these challenges through workplace safety regulations and expanded health care access is crucial to improving outcomes for this integral population in the workforce. Type of study/level of evidence Economic and Decision Analyses IIIb.