Bivariate Statistics
Approximately 2.4% of ambulatory care visits were for work-related conditions (1,179 of 48,054 visits in the NAMCS sample). Of the work-related visits, 11.9% were made by African-American patients and 18.7% involved Hispanic patients. Vis its by African-American patients represented a slightly greater proportion of visits for care of work-related conditions than for nonwork-related conditions in the NAMCS sample (11.9% vs. 10.9%). Visits by Hispanic patients accounted for a much greater proportion of visits for care of work-related conditions than for nonwork-related conditions in the NAMCS sample (18.7% vs. 9.6%).
Table 1. Patient Demographic Characteristics, by Patients’ Race/Ethnicity, Office Visits for Work-Related Conditions, Weighted Percent Distribution (n=l,179)
| Patient Race | Hispanic Ethnicity | |||
| African-American | White | Hispanic | Non-Hispanic | |
| Proportion of all visits for | ||||
| work-related conditions |
11.9 |
83.7 |
18.7 |
81.3 |
| Age | ||||
| <15 |
0.2 |
0.7 |
0.5 |
0.8 |
| 15-24 |
6.3 |
9.8 |
12.9 |
9.2 |
| 25-44 |
54.0 |
52.8 |
53.1 |
54.1 |
| 45-64 |
35.3 |
33.0 |
29.6 |
32.3 |
| 65-74 |
4.1 |
2.4 |
1.4 |
2.8 |
| >75 |
0.0 |
1.3 |
2.4 |
0.8 |
| Age (mean, in years) |
42.1 |
40.9 |
40.3 |
40.7 |
| Sex | ||||
| Female |
43.2 |
36.6 |
39.3 |
36.4 |
| Male |
56.8 |
63.4 |
60.7 |
63.6 |
| Race | ||||
| White |
95.3 |
86.5 |
||
| Black |
4.7 |
13.5 |
||
| Ethnicity | ||||
| Hispanic origin |
7.1 |
19.6 |
||
| Not Hispanic |
92.9 |
80.4 |
||
Demographic characteristics of African-American and white patients receiving care for work-related conditions are summarized in Table 1, along with similar statistics for Hispanic and non-Hispanic patients. The age distributions were similar among African Americans compared to whites and among Hispanics compared to non-Hispanics. The proportion of African-American patients who were female (43.2%) was somewhat greater than the proportion of white patients who were female (36.6%), but that difference was not statistically significant (p=0.23). cialis professional online
Table 2. Practice Characteristics, by Patients’ Race/Ethnicity Office Visits For Work-Related Conditions, Weighted Percent Distribution (n=l,179)
| African- |
Non- |
|||||
| American | White | P Value | Hispanic | Hispanic | P Value | |
| Office Type | ||||||
| Private practice |
76.3 |
81.1 |
0.18 |
71.8 |
85.0 |
0.0001 |
| Clinic/urgicenter |
14.1 |
12.0 |
0.48 |
18.1 |
8.1 |
0.0001 |
| Private clinic |
2.5 |
1.4 |
0.32 |
0.8 |
1.8 |
0.35 |
| Neighborhood mental health center |
1.9 |
1.6 |
0.85 |
3.8 |
0.6 |
0.0007 |
| Local government clinic |
0.6 |
0.6 |
0.98 |
0.0 |
0.9 |
0.22 |
| HMO |
4.6 |
3.2 |
0.39 |
5.5 |
3.6 |
0.26 |
| Solo practice |
38.2 |
35.2 |
0.48 |
33.5 |
41.0 |
0.07 |
| Ownership of Medical Practice | ||||||
| Physician/group |
67.2 |
78.2 |
0.0043 |
73.3 |
80.5 |
0.04 |
| Hospital |
8.1 |
7.6 |
0.85 |
2.0 |
5.5 |
0.06 |
| Healthcare corporation |
15.5 |
8.8 |
0.01 |
12.3 |
6.9 |
0.02 |
| HMO |
4.4 |
2.5 |
0.22 |
7.4 |
2.5 |
0.001 |
| Other |
4.8 |
2.8 |
0.20 |
5.1 |
4.7 |
0.86 |
| Geographic Region of Practice | ||||||
| Northeast |
12.6 |
19.3 |
0.05 |
10.8 |
18.6 |
0.01 |
| Midwest |
26.2 |
22.4 |
0.31 |
4.9 |
23.3 |
0.0001 |
| South |
42.7 |
25.3 |
O.0001 |
31.2 |
28.6 |
0.48 |
| West |
18.5 |
33.0 |
0.0005 |
53.1 |
29.5 |
0.0001 |
| Medical practice is located in an | ||||||
| urban area (MSA) |
84.4 |
78.6 |
0.11 |
92.0 |
75.6 |
0.0001 |
Practice characteristics for patients with work-related disorders stratified by race and ethnicity are summarized in Table 2. Compared to non-Hispanics, Hispanic patients were more likely to be seen at practices owned by a private healthcare corporation or an HMO, at an urgent care setting and in an urban area. They were less likely than non-Hispanics to be seen in a private physician practice. African-American patients were also more likely than whites to receive care in a practice owned by a private healthcare corporation. Substantial regional differences in the site of visits were observed, with visits by African-American patients occurring more commonly in the south and less often in the western and northeastern United States, compared to white patients. Relative to non-Hispanics, visits by Hispanic patients were more likely to be in the west and less likely to be in the mid-western or northeastern United States. risperdal medication
Table 3. Medical Care Characteristics, by Patients’ Race/Ethnicity Office Visits For Work-Related Conditions, Weighted Percent Distribution (n=l/179)
| African-American | White | P Value | Hispanic | Non-Hispanic | P Value | |
|
Major Reason for the Visit Acute problem 42.9 Chronic problem, routine 23.7 Chronic problem, flareup 12.8 Pre- or postsurgery/injury follow-up 19.9 Nonillness (e.g,. routine exam) 0.6 |
45.2 19.0
9.9 22.9 3.0 |
0.62 0.19 0.29 0.43 0.11 | 48.8 19.3
7.0 24.3 0.6 |
43.6 19.9 10.5 22.0 3.9 | 0.23 0.85 0.17 0.52 0.03 | |
| Physician’s Diagnosis of Patient’s Condition Diseases of musculoskeletal system Acute injury and poisoning All other diagnoses Unknown | 34.6 39.1 26.3 0.0 | 26.5 44.5 27.1 1.9 | 0.04 0.22 0.84 0.10 | 27.4 52.0 17.1 3.5 | 26.5 44.8 27.5 1.2 | 0.81 0.09 0.005 0.04 |
| The visit was related to a self-inflicted injury or poisoning | 0.2 | 0.2 |
0.92 |
0.0 | 0.3 |
0.05 |
| The patient’s condition was the result of an assault | 3.7 | 3.2 |
0.92 |
1.2 | 2.7 |
0.05 |
| Diagnostic and screening services were provided | 47.2 | 54.5 |
0.11 |
51.8 | 53.9 |
0.62 |
|
Blood pressure was taken during the visit |
20.7 | 30.5 |
0.02 |
27.8 | 31.1 |
0.40 |
|
X-ray was taken during the visit |
20.9 | 19.9 |
0.79 |
34.6 | 16.4 |
0.0001 |
| Therapeutic and preventive services were provided | 48.8 | 47.8 |
0.83 |
54.7 | 50.5 |
0.31 |
| Exercise counseling and education was provided | 12.5 | 14.5 |
0.54 |
13.9 | 16.0 |
0.50 |
| Injury prevention counseling and education was provided | 7.3 | 12.1 |
0.10 |
16.0 | 11.9 |
0.14 |
| Mental health counseling and education was provided | 5.6 | 1.1 |
O.0001 |
1.3 | 2.2 |
0.47 |
|
Surgical procedures were performed |
0.7 | 3.5 |
0.08 |
2.5 | 2.9 |
0.79 |
| Visit Involved… Physiotherapy Psychotherapy Psychopharmacotherapy | 29.5 3.3 3.9 | 21.0 2.8 2.2 | 0.02 0.77 0.22 | 27.6 4.3 2.4 | 22.5 3.3 3.0 | 0.15 0.50 0.68 |
| At least one drug was prescribed during the visit | 47.7 | 49.0 |
0.76 |
39.7 | 51.2 |
0.007 |
Table 3 summarizes basic characteristics of care stratified by race and ethnicity. In general, the distribution of patients’ diagnoses and the major reasons for the visit differed little between African-American and white patients seen for work-related conditions, although African-American patients were somewhat more likely to be seen for diseases of the musculoskeletal system. Likewise, there were few significant differences between Hispanic and non-Hispanic patients with respect to diagnosis and reasons for the visit. No significant differences between groups were observed with respect to the amount of time spent with the physician, the proportion of visits involving diagnostic and screening services, the provision of therapeutic and preventive services, and whether the physician was the patient’s regular primary care provider. viagra plus
Table 3. continued
| African- |
Non- |
|||||
| American | White | P Value | Hispanic | Hispanic | P Value | |
| Medical Providers Seen during the Visit | ||||||
| Physician |
90.6 |
96.5 |
<0.001 |
91.5 |
96.3 |
0.007 |
| Physician assistant |
3.1 |
2.0 |
0.38 |
3.9 |
1.7 |
0.07 |
| RN |
4.4 |
9.5 |
0.05 |
4.2 |
10.5 |
0.01 |
| LPN |
7.2 |
11.1 |
0.15 |
4.6 |
11.9 |
0.005 |
| Medical/nursing assistant |
12.1 |
15.4 |
0.31 |
10.5 |
17.1 |
0.03 |
| Other |
4.7 |
5.6 |
0.49 |
5.0 |
7.1 |
0.46 |
| Physician Specialty | ||||||
| General and family practice |
27.6 |
22.5 |
0.18 |
9.6 |
26.7 |
O.0001 |
| Internal medicine |
10.5 |
11.2 |
0.78 |
16.0 |
11.2 |
0.09 |
| Orthopedic surgery |
26.1 |
33.8 |
0.07 |
38.4 |
29.7 |
0.03 |
| Psychiatry |
3.8 |
2.7 |
0.43 |
4.2 |
2.6 |
0.27 |
| General surgery |
1.0 |
3.3 |
0.14 |
1.8 |
2.4 |
0.65 |
| All other specialties |
31.0 |
26.5 |
0.26 |
29.9 |
27.4 |
0.50 |
| Provider is the patient’s regular primary | ||||||
| care physician |
25.6 |
24.9 |
0.63 |
23.0 |
29.4 |
0.06 |
| Primary Expected Source of Payment | ||||||
| for the Visit | ||||||
| Private insurance |
11.2 |
12.5 |
0.66 |
5.1 |
13.8 |
0.002 |
| Medicare |
0.5 |
2.7 |
0.12 |
2.9 |
1.6 |
0.25 |
| Medicaid |
2.2 |
0.6 |
0.04 |
0.0 |
1.0 |
0.19 |
| Self-pay |
1.0 |
1.4 |
0.69 |
0.6 |
1.8 |
0.27 |
| Workers’ compensation |
83.8 |
81.9 |
0.58 |
87.6 |
81.3 |
0.05 |
| No charge |
0.0 |
0.1 |
0.69 |
0.5 |
0.0 |
0.15 |
| Other |
1.3 |
0.5 |
0.29 |
1.5 |
0.4 |
0.10 |
| Unknown |
0.0 |
0.3 |
0.49 |
1.8 |
0.1 |
0.004 |
| Care was provided in an HMO setting |
19.7 |
11.6 |
0.03 |
12.9 |
14.4 |
0.0002 |
| Capitated payment basis for the visit |
2.7 |
5.0 |
0.38 |
3.7 |
3.9 |
0.005 |
| Provider has not previously seen this | ||||||
| patient (new patient) |
15.8 |
22.3 |
0.08 |
25.7 |
21.4 |
0.22 |
| Patient was referred by another | ||||||
| physician or health plan |
26.5 |
28.7 |
0.09 |
27.3 |
27.6 |
0.36 |
| Authorization from the insurer was | ||||||
| required for care |
40.6 |
35.6 |
0.13 |
51.4 |
32.8 |
O.0001 |
| Time spent with physician (mean | ||||||
| number of minutes) |
19.3 |
18.0 |
0.25 |
17.6 |
18.5 |
0.39 |
Compared to whites, African-American patients receiving care for a work-related condition were less likely to be treated by a physician and less likely to have their blood pressure taken during the visit. They were more likely than whites to receive mental health counseling and physiotherapy, have their visit paid for by Medicaid and to receive care in an HMO setting. African Americans did not differ significantly from whites with respect to the provision of x-rays, surgical procedures, the ordering or administration of prescription medication, the specialty of the physician providing treatment or the need for the clinician to obtain insurer authorization for care.
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Hispanic patients receiving care for work-related conditions were significantly more likely than non-Hispanics to be seen by an orthopedic specialist, have an x-ray taken during the visit, require insurer authorization for care and be covered by workers’ compensation insurance. They were less likely than non-Hispanic patients to be seen by a physician, nurse, medical assistant or a general/family medicine practitioner during the visit; have a canadian prescription drugs ordered or administered; pay for their visit using private insurance; and receive care in an HMO setting. There were no significant differences between Hispanics and non-Hispanics with respect to receiving physiotherapy, measuring blood pressure, surgical procedures or being seen by their regular primary care physician.
































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