Physician perceptions of access to quality care in California's workers' compensation system

We measured the association of physician perceptions of access to quality care with intentions to change workers' compensation (WC) participation levels, barriers to delivery of quality care, levels of payment, and type of provider after the implementation of California WC reforms in 2004.

Bivariate and logistic regression models were employed using a representative survey of WC providers.

The analyses revealed that intentions to quit or decrease the volume of WC patients, reporting utilization review as a barrier to quality care, and being a chiropractor or acupuncturist were significantly associated with perceptions of decline in access or quality since 2004 and the belief that injured workers do not have access to quality care.

The results indicate specific aspects of WC reform that lead to negative perceptions among providers and require further scrutiny and improvement.