Association between socioeconomic position and occupational health service utilisation trajectories among young municipal employees in Finland
Hilla Sumanen , Jaakko Harkko , Kustaa Piha , Olli Pietiläinen , Ossi Rahkonen , Anne Kouvonen Piotrowska
AbstractObjectivesTo identify groups of municipal employees between the ages of 20 and 34 years with distinct utilisation trajectories of primary care services provided by occupational health service (OHS), measured as the annual number of OHS visits, and to identify demographic and socioeconomic risk factors that distinguish employees in the high utilisation trajectory group(s).MethodsThe present study is a retrospective register-based cohort study. All municipal employees of the City of Helsinki, Finland, aged 20–34 in the Helsinki Health Study, recruited from 2004 to 2013, with follow-up data for 4 years were included in the study (n=9762). The outcome measure was group-based trajectories of OHS utilisation, identified with a group-based trajectory analysis. The demographic and socioeconomic variables used to predict the outcome were age, first language, educational level and occupational class. The analyses were stratified by gender.ResultsA large proportion of the young employees do not use OHS. Trajectory groups of ‘No visits’ (50%), ‘Low/increasing’ (18%), ‘Low/decreasing’ (22%) and ‘High/recurrent’ (10%) use were identified. We found occupational class differences in OHS utilisation patterns showing that lower occupational classes had a higher propensity for ‘High/recurrent’ OHS utilisation for both genders.ConclusionsPreventive measures should be targeted particularly to the trajectory groups of ‘Low/increasing’ and ‘High/recurrent’ in order to intervene early. In addition, OHS utilisation should be closely monitored among the two lowest occupational classes. More research with longitudinal OHS data is needed.
|Journal series||BMJ Open, ISSN 2044-6055, (N/A 100 pkt)|
|Publication size in sheets||0.5|
|Publication indicators||: 2018 = 1.145; : 2018 = 2.376 (2) - 2018=2.863 (5)|
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