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Office-Based Medical Care for Work-Related Conditions: Findings from the National Ambulatory Medical Care Survey, 1997–1998

Dembe, Allard E. ScD; Savageau, Judith A. MPH; Amick, Benjamin C. III, PhD; Banks, Steven M. PhD

Journal of Occupational & Environmental Medicine: December 2002 - Volume 44 - Issue 12 - pp 1106-1117

Learning Objectives:

* Identify characteristic patterns of ambulatory medical care provided to patients with work-related conditions.

* Explain how individuals who make medical visits for work-related conditions differ from other patients demographically and in the type of health care setting in which they are seen.

* Contrast the type of medical care and services received by patients seen for work-related and non-work-related reasons.

* Recall strategies prompted by the findings of this survey that could improve the outcome in patients who seek medical care for work-related disorders.

Data from the 1997 and 1998 National Ambulatory Medical Care Surveys were analyzed to describe nationally representative patterns of office-based ambulatory medical care for work-related injuries and illnesses. Key dimensions of care included patient demographics, diagnoses, utilization of services, provider and payer information, and characteristics of the clinical setting in which care was delivered. Multivariate analyses revealed that compared to visits for nonwork related conditions, ambulatory care visits for work-related conditions are more likely to involve x-rays, injury prevention counseling, and physiotherapy. Surgical procedures, mental health counseling, prescription drug medication, and the taking of blood pressure were found to be relatively less common. Additionally, authorization for care was required considerably more often at visits for work-related conditions, and the provider for patients with work-related conditions was less likely to be the patient’s regular primary care physician.

From the University of Massachusetts Medical School, Shrrewsbury, MA (Dr Dembe, Ms Savageau, Dr Banks); and the University of Texas-Houston School of Public Health, (Houston, TX)(Dr Amick).

Address correspondence to: Allard E. Dembe, ScD, Associate Professor and Senior Research Scientist, Center for Health Policy and Research, University of Massachusetts Medical School, 222 Maple Avenue, Higgins Building Shrewsbury, MA 01545; e-mail:

The corresponding author has no commercial interest related to this article.

Copyright © by American College of Occupational and Environmental Medicine

©2002The American College of Occupational and Environmental Medicine