Won Jong Uk, Dembe Allard E
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Ann Fam Med. 2006 Mar-Apr;4(2):138-47. doi: 10.1370/afm.515.
Many family doctors provide care to patients with occupational injuries and illnesses, but little is known about the type of medical services provided, or how they compare with services provided by other types of physicians. This study used national data to develop a statistical profile of office-based medical care delivered by family physicians to patients with work-related disorders.
Using data from 4 years (1997-2000) of the National Ambulatory Medical Care Survey, we classified visits for patients with work-related conditions according to patient and physician characteristics, services provided, and other visit characteristics. For comparison, we also compiled profiles for visits to other types of physicians for treatment of work-related disorders, and for visits to family physicians for treatment of nonoccupational conditions.
Analyses were based on 96,183 office visits made to 4,947 physicians. A majority of visits made to family physicians for occupational conditions involved patients seeing their regular primary care doctor. Possibly for this reason, patients at these visits were more likely to have their blood pressure taken, receive diagnostic and screening services, and have prescription drugs prescribed or administered, compared with patients seeing other types of physicians. Only 73.3% of visits to family physicians for work-related disorders were expected to be paid for by workers' compensation insurance.
Our findings suggest that the distinctive types of care provided by family physicians to injured workers may be related to their role as the patients' regular physician. This finding is relevant to the proposals being considered by many states to expand employers' and insurers' ability to choose the treating physician in workers' compensation cases.
许多家庭医生为职业受伤和患病的患者提供护理，但对于所提供的医疗服务类型，或者这些服务与其他类型医生提供的服务相比情况如何，人们了解甚少。本研究利用全国性数据，对家庭医生为患有与工作相关疾病的患者提供的门诊医疗护理进行了统计描述。
利用全国门诊医疗护理调查4年（1997 - 2000年）的数据，我们根据患者和医生特征、提供的服务以及其他就诊特征，对患有与工作相关疾病患者的就诊情况进行了分类。为作比较，我们还整理了其他类型医生治疗与工作相关疾病的就诊情况资料，以及家庭医生治疗非职业性疾病的就诊情况资料。
分析基于对4947名医生进行的96183次门诊就诊。大多数因职业疾病就诊于家庭医生的患者是去看他们的常规初级保健医生。可能正因如此，与看其他类型医生的患者相比，这些就诊患者更有可能接受血压测量、接受诊断和筛查服务，以及开具或使用处方药。因与工作相关疾病就诊于家庭医生的患者中，只有73.3%的就诊预计由工伤赔偿保险支付费用。
我们的研究结果表明，家庭医生为受伤工人提供的独特护理类型可能与其作为患者常规医生的角色有关。这一发现与许多州正在考虑的扩大雇主和保险公司在工伤赔偿案件中选择治疗医生能力的提议相关。
