Integrating occupational health services and occupational prevention services.
BACKGROUND
Despite the human and monetary costs of occupational injury and illness, occupational health care has focused more on treatment than prevention, and prevention is not part of many clinical occupational health practices. This represents a failure of occupational health care to meet the health care needs of the working patients.


METHODS
MEDLINE searches were conducted for literature on occupational medical treatment and the prevention of occupational injury and illness were reviewed to for linkages between prevention and treatment. Policy discussions which identify examples of programs that integrated prevention and treatment were included.


RESULTS
Although examples of the integration of clinical and preventive occupational health services exist, there are challenges and barriers to such integration. These include inaction by clinicians who do not recognize their potential role in prevention; the absence of a relationship between the clinician and an employer willing to participate in prevention; economic disincentives against prevention; and the absence of tools that evaluate clinicians on their performance in prevention.


CONCLUSIONS
Research is needed to improve and promote clinical occupational health preventive services.
Rudolph
L
L
Division of Workers' Compensation, 455 Golden Gate Ave. 9th Floor, San Francisco, California 94102, USA. lrudolph@hq.dir.ca.gov
Deitchman
S
S
Dervin
K
K
D003266:Continuity of Patient Care; D006302:Health Services Research; D006801:Humans; D007400:Interprofessional Relations; D008329:Managed Care Programs; D009784:Occupational Diseases / Q000517:prevention & control; D009786:Occupational Health Services / Q000458:organization & administration*; D011314:Preventive Health Services / Q000458:organization & administration*; D014481:United States