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与芬兰人就诊于职业健康医生相关的因素。

Factors associated with visits to occupational health physicians in Finland.

机构信息

Finnish Institute of Occupational Health, Helsinki, Finland.

出版信息

Occup Med (Lond). 2010 Jan;60(1):29-35. doi: 10.1093/occmed/kqp128. Epub 2009 Sep 4.

Abstract

BACKGROUND

In Finland, employers can offer primary care to employees in addition to obligatory occupational health services (OHS).

AIMS

To analyse factors associated with visits to seek primary care from occupational health physicians (OH physicians) and compared with visits to physicians in municipal health centres, private clinics and hospital outpatient clinics.

METHODS

The subjects of this population-based cross-sectional survey comprised 1753 randomly selected employed Finns aged 25-64 years covered by OHS including primary care. The associations between visits to physicians during the past 6 months and factors related to work and perceived health were tested using Poisson regression analysis.

RESULTS

Provision of primary care in OHS increased visits to OH physicians but decreased visits to municipal health centre physicians. Among both genders, long-standing illnesses impairing work ability had the strongest associations with visits to all physicians. Among men, the factors associated with visits to OH physicians were long-standing illnesses without effect on work ability, requirement of sickness certificate from the first day of sickness, OHS arranged in private clinics and moderate stress symptoms. Among women, lower vocational level, OHS arranged in private clinics or joint-model OHS units, moderate stress symptoms and workplace harassment were associated with visits to OH physicians.

CONCLUSIONS

Primary care in OHS enables OH physicians to reach workers with work-related health problems, thus enabling interventions on working conditions and work ability. Moreover, OHS seem to be a very important health care provider in Finland.

摘要

背景

在芬兰,雇主除了提供强制性的职业健康服务(OHS)之外,还可以为员工提供基本医疗服务。

目的

分析与职业健康医生(OH 医生)就诊相关的因素,并与市立医疗中心、私人诊所和医院门诊就诊进行比较。

方法

本基于人群的横断面调查对象为 1753 名随机选择的 25-64 岁芬兰受 OHS 覆盖的就业者,其中包括基本医疗服务。使用泊松回归分析测试过去 6 个月就诊与与工作相关和感知健康相关的因素之间的关联。

结果

OHS 提供基本医疗服务增加了 OH 医生的就诊次数,但减少了市立医疗中心医生的就诊次数。在两性中,长期影响工作能力的疾病与所有医生的就诊次数均有最强关联。对于男性,与 OH 医生就诊相关的因素是长期不影响工作能力的疾病、从发病第一天起就需要病假证明、OHS 在私人诊所安排和中度压力症状。对于女性,较低的职业水平、OHS 在私人诊所或联合模式 OHS 单位安排、中度压力症状和工作场所骚扰与 OH 医生就诊相关。

结论

OHS 中的基本医疗服务使 OH 医生能够接触到与工作相关的健康问题的工人,从而能够干预工作条件和工作能力。此外,OHS 在芬兰似乎是一个非常重要的医疗保健提供者。

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