1. Patients’ workplace factors and their impact on
primary healthcare utilization
Sally P. Weaver, PhD, MD*, Dawn Carlson, PhD**, Merideth Ferguson, PhD***
*Family Medicine Residency Program, Waco, TX; **Baylor University School of Business, Waco, TX; ***Utah State University, Logan, UT
Background
Subjects who have uncivil coworkers (puts down employee/pays little attention, makes derogatory remarks, etc) are:
More likely to have answered YES to a CAGE alcohol abuse screen
More likely to have had a recent lipid panel
More likely to have had a doctor visit
Coworker support (having coworkers who listen/back them or who are helpful):
Lower likelihood of:
Having an ultrasound, metabolic panel, hepatitis screen or a doctor’s visit.
Asked the participant’s perceptions with respect to:
Work-family conflict:
I have to miss family activities due to work responsibilities
Emotionally drained after work- prevents me contributing to my family
Behaviors that make me effective at work do not help be a better parent/spouse
Work – family enrichment:
My job helps me be a better family member
My job makes me happy and a better family member
My job helps me feel personally fulfilled and helps me be a better family member
Work – family balance:
I successfully balance my work and family life
I do a good job meeting role expectations in my work and family life
--There is little published research documenting health care utilization associated with workplace factors.
--Most studies rely solely on self-report data rather than physician diagnoses and other documented health outcome data.
--One exception is a study by Butler et. al. (2009) that investigated health outcomes related to perceived flexibility at work and found that workplace flexibility relates to better health.
Health Behaviors and Job Stress
Also asked the participant’s perceptions with respect to:
Abusive supervision, coworker incivility, work demands
Schedule control, psychological distress
Coworker support, supervisor support
Demographic questions related to gender, age, race, and other work, family characteristics and some health behaviors (sleep, alcohol use, tobacco use and exercise).
Objective
--To investigate health care outcomes related to workplace factors such as interactions with supervisors and coworkers, job characteristics, and the interface between work and family/non work life.
Results
Methods
Conclusions/Discussion
If you have an abusive supervisor (who ridicules/puts down employee, etc.):
You are less likely to get a flu vaccine (p<0.05)
More likely to get a urine drug test (p<0.05)
More likely to be admitted to the hospital (p<0.01)
More likely to smoke (p<0.01)
Greater supervisor support (cares, values employee, etc.) is correlated with:
a lower likelihood of having a doctor visit (p<0.001)
fewer sleep problems (p<0.001) and
a greater chance of exercising (p=0.01)
Setting: Community Health Center in Central Texas.
Participants: Clinic patients >18yo, working at least part-time, with a supervisor & coworkers, and who did not live alone. N= 343
This study is one of the first to report on whether job issues relate to employees’ healthcare utilization.
Workplace stressors such as abusive supervisor/feeling burnout had a detrimental effect on a participant’s health.
Workplace resources (supervisor /coworker support) had a beneficial health effect.
Healthcare providers should ask patients about workplace stressors that may be triggers for poor health outcomes.
--Surveys were distributed in paper form in patient waiting rooms (and online survey for employee patients)
--Participants gave permission for access to some of their electronic health records (EHR) for 12 months before and 12 months after the survey.
--EHR data included number of visits, some labs, diagnoses and prescriptions.
References
Butler, A. B., Grzywacz, J. G., Ettner, S. L., & Liu, B. (2009). Workplace flexibility, self-reported health, and health care utilization. Work & Stress, 23(1),