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Quantifying the Value of Worksite Clinic Nonoccupational Health Care Services: A Critical Analysis and Review of the Literature

Sherman, Bruce W. MD; Fabius, Raymond J. MD

Journal of Occupational and Environmental Medicine: April 2012 - Volume 54 - Issue 4 - p 394–403
doi: 10.1097/JOM.0b013e31824b2157
Original Articles

Objective: Confusion exists regarding the approach to quantifying employer value of worksite nonoccupational care. A literature review and analysis was performed to characterize and critically evaluate existing methods to quantify the value of these services.

Methods: PubMed was searched for publications describing measurement of value of nonoccupational worksite clinic services in US locations. Nineteen studies and two methodologic reviews met criteria for further analysis.

Results: Return-on-investment calculations were commonly based on the comparative cost-effectiveness of worksite clinic services relative to community health care. Only one study evaluated the impact of worksite clinics on health care cost trend among clinic users, and none assessed the impact on total health and productivity costs.

Conclusions: Significant variability exists among current methods for calculating return on investment of nonoccupational worksite health care services; methodologic approaches are poorly aligned with employer health care cost containment objectives.

From the Employers Health Coalition (Dr Sherman), Canton, OH; and Department of Medicine (Dr Sherman), Case Western Reserve University School of Medicine, Cleveland, OH; and Thomson Reuters Healthcare (Dr Fabius), Ann Arbor, MI.

Address correspondence to: Bruce Sherman, MD, 3175 Belvoir Blvd, Shaker Heights, OH 44122 (

Disclosure: No external funding was provided for this research. The authors declare no actual or potential conflicts of interest.

Authors Sherman and Fabius have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM Editorial Board and planners have no financial interest related to this research.

©2012The American College of Occupational and Environmental Medicine