Racial and ethnic variations in office-based medical care for work-related injuries and illnesses.
OBJECTIVE
This exploratory study uses nationally representative data to evaluate the extent to which ambulatory care for work-related conditions varies by patients' race and ethnicity.


METHODS
Using the National Ambulatory Medical Care Survey (NAMCS) for 1997 and 1998, we describe medical care for work-related conditions, stratifying by whether the patient self-identified as African-American, white, Hispanic and/or non-Hispanic. Multivariate regression analyses were conducted to evaluate the impact of patient race and ethnicity on care, controlling for age, gender, geographical region and MSA (urban/rural) status.


RESULTS
Compared to white patients, African-American patients were more likely to receive mental health counseling and physical therapy and less likely to see a nurse, after controlling for age, gender, geographical region and MSA status. Hispanic patients were more likely to receive x-rays and need insurer authorization for care and less likely to receive a prescription drug or to see a physician, compared to non-Hispanics.


CONCLUSIONS
This is the nation's first study to describe socially based differences in medical care provided for patients with work-related injuries and illnesses. Identifying areas in which these variations in care exist is a critical first step in ensuring that equitable care is afforded to all injured workers.
Dembe
Allard E
AE
Center for Health Policy and Research, University of Massachusetts Medical School, 222 Maple Ave., Higgins Building, Shrewsbury, MA 01545, USA. Allard.Dembe@umassmed.edu
Savageau
Judith A
JA
Amick
Benjamin C
BC
Banks
Steven M
SM
D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000592:standards* / Q000639:trends; D001294:Attitude to Health / Q000208:ethnology*; D015331:Cohort Studies; D016001:Confidence Intervals; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D005791:Patient Care / Q000592:standards* / Q000639:trends; D011336:Probability; D012042:Registries; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D017132:Workplace