O-053 Medical Accessibility and Under-Reporting of Occupational Diseases: Effect of Travel Distance and Travel Time

Introduction Considering the lack of time to visit clinics for workers and the scarcity of occupational physicians and occupational medicine clinics, under-reporting of occupational diseases (ODs) could be attributed to poor medical accessibility. Thus, our study tries to evaluate how reporting of ODs is impeded by long travel distance/time (TD/TT) to nearest major occupation medicine clinics. Methods Using data from Network of Occupational Diseases and Injuries Service (Taiwan’s OD surveillance system) and annual Manpower Survey, we calculate each town’s incidence rate of ODs (IROD) and expected IROD based on industry types and job titles. Each town’s TD/TT to nearest major occupation medicine clinics is estimated by Google Maps’ Distance Matrix API. We use the Quasi-Poisson regression model to investigate the effect of TD and TT on IROD, while industry types and job titles are adjusted by offsetting expected IROD, and carry out subgroup analysis to check effect of employment status and sickness absence. Results After adjusting industry types and job titles, TD and TT have significant effects on IROD. As TD/TT increases by 10 km/10 mins, IROD decreases by 12.54%/12.06%. It is estimated that around 200 OD cases (40%) are under-reported annually due to poor medical accessibility. In subgroup analysis, only workers who never have sickness absence or keep their jobs are still significantly affected by TD and TT. Discussion Our study shows how poor medical accessibility leads to under-reporting, especially for minor cases, and up to 40% cases are under-reported. Conclusion Using this method, we can identify areas with poor medical accessibility and evaluate cost-effectiveness of adding reporting hospitals.