title: Paid sick days and health care use: an analysis of the 2007 national health interview survey data.
abstract: BACKGROUND
  In identifying factors of health care use, past research has focused on individual-level characteristics or on the health care system itself. This study investigates whether access to paid sick days, an amenable environmental factor outside the health care system, is associated with primary and emergency care use.
  
  
  METHODS
  A nationally representative sample of 14,302 U.S. working adults extracted from the 2007 National Health Interview Survey data was used. Multiple logistic regressions were performed, controlling for demographic variables, health conditions and status, and access to health care.
  
  
  RESULTS
  Workers with lower socioeconomic status, poorer health status, or without health insurance or regular places for care were more likely to lack paid sick days than higher-status workers. For all U.S. working adults, access to paid sick days benefits was significantly associated with increased use of outpatient care but not with reduced use of ER. For U.S. working adults with health insurance coverage, access to paid sick days benefits was significantly associated with increased use of outpatient care and reduced use of emergency care.
  
  
  CONCLUSIONS
  A public policy mandating paid sick days may help facilitate timely access to primary care, reduce avoidable emergency care use, and reduce health disparities among workers.
authors.affiliation: Alcohol Research Group, Public Health Institute, Emeryville, CA, USA. wcook@arg.org
authors.forename: Won Kim
authors.initials: WK
authors.lastname: Cook
mesh_terms: D000293:Adolescent; D000328:Adult; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011320:Primary Health Care / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult