Classification of occupational health care visits related to work ability varies

Background In the Finnish occupational health care (OHC) visits related to work ability can be seen as preventive (mandatory) OHC, in which case the visit is recorded as reimbursement category (RC) I, or as medical care (voluntary), in which case the visit is recorded as RC II. The classification affects the amount of reimbursement paid by Social Insurance Institution of Finland to the employer and the statistics on OHC. Reimbursement is paid primarily for preventive OHC.

Methods An electronic survey was used to investigate the views of physicians in OHC (n=289) on reimbursement classifications of 13 imaginary patient cases related to work ability.

Results The majority of cases were classified as RC I, but the variation was high. RC I classification was justified by the threat of disability, actions to support work ability or cooperation with the workplace. The RC II classification was favored in case of diagnostic examination of the illness or the use of health expense insurance.

Conclusion Visits related to work ability are mainly perceived as preventive OHC, but physicians’ views vary a lot. Views differ especially when analyzing illness affecting work capacity. To strengthen the uniform services of OHC, the guidelines for classification should be clarified.