Factors associated with visits to occupational health physicians in Finland.

Background: In Finland, employers can offer primary care to employees in addition to obligatory occupational health services (OHS).

Aims: To analyse factors associated with visits to seek primary care from occupational health physicians (OH physicians) and compared with visits to physicians in municipal health centres, private clinics and hospital outpatient clinics.

Methods: The subjects of this population-based cross-sectional survey comprised 1753 randomly selected employed Finns aged 25-64 years covered by OHS including primary care. The associations between visits to physicians during the past 6 months and factors related to work and perceived health were tested using Poisson regression analysis.

Results: Provision of primary care in OHS increased visits to OH physicians but decreased visits to municipal health centre physicians. Among both genders, long-standing illnesses impairing work ability had the strongest associations with visits to all physicians. Among men, the factors associated with visits to OH physicians were long-standing illnesses without effect on work ability, requirement of sickness certificate from the first day of sickness, OHS arranged in private clinics and moderate stress symptoms. Among women, lower vocational level, OHS arranged in private clinics or joint-model OHS units, moderate stress symptoms and workplace harassment were associated with visits to OH physicians.

Conclusions: Primary care in OHS enables OH physicians to reach workers with work-related health problems, thus enabling interventions on working conditions and work ability. Moreover, OHS seem to be a very important health care provider in Finland.