title: Hospital support services and the impacts of outsourcing on occupational health and safety.
abstract: Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors.
  
  
  
  This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach.
  
  
  
  Worker's compensation data for hospital CFSWs were analyzed by negative binomial and multiple linear regressions supplemented by iterative thematic analysis of telephone interviews of the same job groups.
  
  
  
  Non-significant decreases in injury rates and days lost per injury were observed in outsourced CFSWs post outsourcing. Significant decreases (P < 0.05) were observed in average costs per injury for cleaners post outsourcing. Outsourced workers interviewed implied instances of underreporting workplace injuries.
  
  
  
  This mixed methods study describes the impact of outsourcing on OHS of healthcare workers in British Columbia. Results will be helpful for policy-makers and workplace regulators to assess program effectiveness for outsourced workers.
authors.affiliation: a School of Population and Public Health , University of British Columbia , Vancouver , Canada.
authors.forename: Pearl
authors.initials: P
authors.lastname: Siganporia
authors.affiliation: a School of Population and Public Health , University of British Columbia , Vancouver , Canada.
authors.forename: George
authors.initials: G
authors.lastname: Astrakianakis
authors.affiliation: b Department of Health Policy and Management , New York Medical College , New York , NY , USA.
authors.forename: Hasanat
authors.initials: H
authors.lastname: Alamgir
authors.affiliation: c Department of Geography , University of Victoria , Victoria , Canada.
authors.forename: Aleck
authors.initials: A
authors.lastname: Ostry
authors.affiliation: d Faculty of Health Sciences , Simon Fraser University , Vancouver , Canada.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Nicol
authors.affiliation: a School of Population and Public Health , University of British Columbia , Vancouver , Canada.
authors.forename: Mieke
authors.initials: M
authors.lastname: Koehoorn
mesh_terms: D001955:British Columbia; D005521:Food Service, Hospital / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D016272:Occupational Health; D060051:Occupational Injuries / Q000453:epidemiology*; D020416:Outsourced Services / Q000706:statistics & numerical data*; D010465:Perception; D014942:Workers' Compensation / Q000706:statistics & numerical data; D017132:Workplace
keywords: Cleaners; Contracting; Food service workers; Healthcare worker; Occupational health and safety; Outsourcing; Re-organization; Underreporting