Occupational issues in episodic care populations.
BACKGROUND
Much care for non-emergency problems is provided at "episodic care" settings (e.g., urgent care and emergency room).


METHODS
Ninety-four subjects, without known occupational disease, who were seeking care for a chronic or sub-acute problem in an episodic care location, were interviewed to assess the frequency and types of occupational health concerns. They were asked whether work probably "caused" or "made worse" their illness and whether their illness "made work difficult."


RESULTS
Categorized hierarchically, 20% reported causation, 15% worsening, and 15% interference of illness with work. (Each was categorized in one category only). Only 50% reported absence of a workplace-health interaction. One-third reported that workplace changes could improve their functional status. Nevertheless, workplace factors were discussed only 21% of the time in physician-patient encounters.


CONCLUSIONS
This study suggests that occupational health issues are frequent in episodic care settings and that the definition of occupational health issues should be broadened to include "made worse" and "illness makes work difficult" as well as the traditional workplace causation definition. Further, episodic care settings present unique opportunities for prevention.
Harber
Philip
P
UCLA Occupational and Environmental Medicine, Department of Family Medicine, Los Angeles, CA 90024, USA. pharber@mednet.ucla.edu
Bublik
Michael
M
Steimberg
Clara
C
Wallace
Jeanne
J
Merz
Brenda
B
D000553:Ambulatory Care / Q000706:statistics & numerical data*; D017050:Episode of Care; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology; D016272:Occupational Health; D010817:Physician-Patient Relations; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology