Disparities in occupational health services: an international comparative study

BackgroundOccupational Health Services (OHS) are comprehensive, multidisciplinary services supplied by various trained workers, including occupational physicians (OP), whose specialty is focused on workers' health.AimsOur study questions are whether the OP/worker ratio may reflect the scope and availability of OHS.MethodsThis comparative study, conducted on globally different OHS, was based on literature analysis of peer-reviewed articles published in journals covering topics of occupational medicine and public health that addressed parameters on the type and scope of OHS provision.ResultsWe described the number of OP/worker ratio, and the correlation to economic parameters (Gross domestic product-GDP, health expenditure, Gini Index-GI) by country. We found that among countries with a GDP per capita higher than US$30,000, only three (US, South Korea and Israel) had a very low OP/worker ratio (about 1:50,000 compared to 1:5,000 in other countries). Looking at all the countries together, there was a statistically significant negative correlation between health expenditure percentage of GDP per capita and OP/worker ratio (rs = -0.54, p = 0.01) and a significant positive correlation between GI and OP/worker ratio (rs = 0.47, p = 0.04).ConclusionsThe lesser the percentage of health expenditure of GDP and the subsequent greater general inequality as reflected by the GI, the lower the OP/worker ratio. The data collected in our comparative study show that the OP/worker ratio is a parameter both easy to define and obtain which best represents the status and disparity of OHS in each country.