Racial and ethnic variations in office-based medical care for work-related injuries and illnesses
Department of Family Medicine and Community Health
Accidents, Occupational; Adolescent; Adult; Aged; Ambulatory Care; Attitude to Health; Cohort Studies; Confidence Intervals; Ethnic Groups; European Continental Ancestry Group; Female; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Outcome Assessment (Health Care); Patient Care; Probability; Registries; Risk Assessment; Socioeconomic Factors; United States; Workplace
Community Health and Preventive Medicine | Preventative Medicine | Primary Care
OBJECTIVES: This exploratory study uses nationally representative data to evaluate the extent to which ambulatory care for work-related conditions varies by patients' race and ethnicity.
METHODS: Using the National Ambulatory Medical Care Survey (NAMCS) for 1997 and 1998, we describe medical care for work-related conditions, stratifying by whether the patient self-identified as African-American, white, Hispanic and/or non-Hispanic. Multivariate regression analyses were conducted to evaluate the impact of patient race and ethnicity on care, controlling for age, gender, geographical region and MSA (urban/rural) status.
RESULTS: Compared to white patients, African-American patients were more likely to receive mental health counseling and physical therapy and less likely to see a nurse, after controlling for age, gender, geographical region and MSA status. Hispanic patients were more likely to receive x-rays and need insurer authorization for care and less likely to receive a prescription drug or to see a physician, compared to non-Hispanics.
CONCLUSIONS: This is the nation's first study to describe socially based differences in medical care provided for patients with work-related injuries and illnesses. Identifying areas in which these variations in care exist is a critical first step in ensuring that equitable care is afforded to all injured workers.
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Citation: J Natl Med Assoc. 2005 Apr;97(4):498-507.