Racial and ethnic variations in office-based medical care for work-related injuries and illnesses.

OBJECTIVES: This exploratory study uses nationally representative data to evaluate the extent to which ambulatory care for work-related conditions varies by patients' race and ethnicity.

METHODS: Using the National Ambulatory Medical Care Survey (NAMCS) for 1997 and 1998, we describe medical care for work-related conditions, stratifying by whether the patient self-identified as African-American, white, Hispanic and/or non-Hispanic. Multivariate regression analyses were conducted to evaluate the impact of patient race and ethnicity on care, controlling for age, gender, geographical region and MSA (urban/rural) status.

RESULTS: Compared to white patients, African-American patients were more likely to receive mental health counseling and physical therapy and less likely to see a nurse, after controlling for age, gender, geographical region and MSA status. Hispanic patients were more likely to receive x-rays and need insurer authorization for care and less likely to receive a prescription drug or to see a physician, compared to non-Hispanics.

CONCLUSIONS: This is the nation's first study to describe socially based differences in medical care provided for patients with work-related injuries and illnesses. Identifying areas in which these variations in care exist is a critical first step in ensuring that equitable care is afforded to all injured workers.