Impact of clinical quality on employee choice of providers for workers' compensation-related medical care.
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.
Jennifer L
JL
Eaton
David C
DC
Mohr
Sheryl
S
Gallarde
Michael J
MJ
Hodgson
D000554:Ambulatory Care Facilities / Q000592:standards; D019090:Case Management; D002568:Certification; D003430:Cross-Sectional Studies; D019983:Guideline Adherence; D006297:Health Services Accessibility; D006801:Humans; D009786:Occupational Health Services / Q000592:standards*; D060051:Occupational Injuries / Q000191:economics / Q000628:therapy*; D009787:Occupational Medicine; D057240:Patient Preference; D010820:Physicians / Q000592:standards; D019984:Quality Indicators, Health Care; D018582:Sick Leave / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D014942:Workers' Compensation