The Relationship Between the Use of a Worksite Medical Home and ED Visits or Hospitalizations

Worksite medical homes may be a good model for improving employeehealth. The aim of this study was to compare the likelihood of being seen in theemergency department (ED) or being hospitalized by level of use (no use, occasional use,or primary care) of a worksite medical home, overall and by type of user (employee,adult dependent, or pediatric dependent). This was a retrospective analysis of claimsdata, using covariate-adjusted logistic regression models for ED visits and inpatienthospitalizations. Secondary data for the years 2006 to 2008 from a company that offersan on-site health care center (HCC) were used. Analyses were based on a data set thatcombines health plan claims and human resources demographic data. Overall, people whodid not use the HCC were more likely to be seen in the ED (adjusted odds ratio [OR] =1.20, 95% confidence interval or CI [1.06, 1.37], P = .005) or to be hospitalized(adjusted OR = 1.58; 95% CI [1.34, 1.86]; P < .0001) compared with those who used theHCC for primary care. Both ED visits and hospitalizations for employees and dependentsin this study were lower among those who used the worksite medical home for primarycare. Worksite medical homes can improve chronic disease management and thus reduce EDvisits and hospitalizations. These findings contribute to growing evidence that worksitemedical homes are potentially cost-effective