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J Natl Med Assoc. 2005 Apr;97(4):498-507.

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

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  • 1Center for Health Policy and Research, University of Massachusetts Medical School, 222 Maple Ave., Higgins Building, Shrewsbury, MA 01545, USA.



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.


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.


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.


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.

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