Psychosocial Workplace Factors and Healthcare Utilization: A Study of Two Employers

Document Type : Original Article


1 Harvard Center for Population & Development Studies, Cambridge, MA, USA

2 The University of Kansas Medical Center, Department of Health Policy and Management, Kansas City, KS, USA

3 Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA

4 Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA

5 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

6 Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

7 RTI International, Research Triangle Park, NC, USA

8 Department of Economics, University of North Carolina Greensboro, Greensboro, NC, USA

9 Harvard Center for Population and Development Studies, T.H. Chan Harvard School of Public Health, Cambridge, MA, USA


While a large literature links psychosocial workplace factors with health and health behaviors, there is very little work connecting psychosocial workplace factors to healthcare utilization.

Survey data were collected from two different employers using computer-assisted telephone interviewing as a part of the Work-Family Health Network (2008-2013): one in the information technology (IT) service industry and one that is responsible for a network of long-term care (LTC) facilities. Participants were surveyed four times at six month intervals. Responses in each wave were used to predict utilization in the following wave. Four utilization measures were outcomes: having at least one emergency room (ER)/Urgent care, having at least one other healthcare visit, number of ER/urgent care visits, and number of other healthcare visits. Population-averaged models using all four waves controlled for health and other factors associated with utilization.

Having above median job demands was positively related to the odds of at least one healthcare visit, odds ratio [OR] 1.37 (P < .01), and the number of healthcare visits, incidence rate ratio (IRR) 1.36 (P < .05), in the LTC sample. Work-to-family conflict was positively associated with the odds of at least one ER/urgent care visit in the LTC sample, OR 1.15 (P < .05), at least one healthcare visit in the IT sample, OR 1.35 (P < .01), and with more visits in the IT sample, IRR 1.35 (P < .01). Greater schedule control was associated with reductions in the number of ER/urgent care visits, IRR 0.71 (P < .05), in the IT sample.

Controlling for other factors, some psychosocial workplace factors were associated with future healthcare utilization. Additional research is needed.


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  • Receive Date: 19 April 2017
  • Revise Date: 22 September 2017
  • Accept Date: 05 November 2017
  • First Publish Date: 01 July 2018