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Impact of Clinical Quality on Employee Choice of Providers for Workers' Compensation–Related Medical Care

Eaton, Jennifer L. MD, MPH; Mohr, David C. PhD; Gallarde, Sheryl MSc; Hodgson, Michael J. MD, MPH

Journal of Occupational and Environmental Medicine: March 2015 - Volume 57 - Issue - p S31–S35
doi: 10.1097/JOM.0000000000000387
Federal Workers' Compensation Supplement

Objective: The study examined the relationship between onsite occupational health practice characteristics, provider choice, and workers' compensation outcome metrics.

Methods: Cross-sectional survey of 140 medical center occupational health clinics within the Department of Veterans Affairs. Multivariate regression models examined how specific clinical quality factors influenced provider choice and workers' compensation measures.

Results: Several practice characteristics were associated with higher rates of in-house care selection—longer hours of operation, greater availability of workers' compensation–related medical services, clinic administration by a board certified physician, physician tenure, and adherence to clinical practice guidelines. Access to onsite, occupational and environmental medicine certified physician-directed care was associated with reductions in disability duration among injured healthcare workers.

Conclusions: These findings suggest that occupational medicine board certification can positively impact provider choice among fully insured patients, which may have implications for other healthcare systems.

From the Occupational Health Group (Dr Eaton), Office of Public Health, Veterans Health Administration; War Related Illness and Injury Study Center (Dr Eaton), VA Medical Center, Washington, DC; Center for Healthcare Organization and Implementation Research (Dr Mohr), Department of Veterans Affairs, VA Boston Healthcare System; Department of Health Policy and Management (Dr Mohr), Boston University School of Public Health, Mass; Oregon Health & Science University (Ms Gallarde), Portland; and Occupational and Environmental Medicine and Health (Dr Hodgson), Washington, DC.

Address correspondence to: Jennifer L. Eaton, MD, MPH, Occupational Health Group, Office of Public Health, Veterans Health Administration, 1717 H St NW Rm 504, Washington, DC 20006 (

This work was supported by operational funds in the Veterans Health Administration.

The authors declare no conflicts of interest.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy, position or views of the Uniformed Services University, the Department of the Army, the Department of the Navy, the Department of Defense, the Veterans Health Administration or the US Government.

Copyright © 2015 by the American College of Occupational and Environmental Medicine