Disparities in occupational health services: an international comparative study

Background: Occupational Health Services (OHS) are comprehensive, multidisciplinary services supplied by various trained workers, including occupational physicians (OP), whose specialty is focused on workers’ health. Aims: Our study questions are whether the OP/worker ratio may reflect the scope and availability of OHS. Methods: This 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. Results: We 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). Conclusions: The 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.