Objective:

to identify the difficulties and needs of medical professionals in occupational health services in Catalonia with respect to carrying out their functions, as prescribed by law.

Methods:

Delphi study in three rounds. The selection of participants was carried out separately for in-house versus outsourced occupational health services. The first round included two open-ended questions: What difficulties do you encounter when performing your duties in your occupational health service? And, what are your needs in terms of being able to perform your duties in your occupational health service? In the second and third rounds, participants ranked the categories identified in the first round according to their importance and relevance. We calculated an inter-rater agreement index (ICC) and an "index of concern (IP)".

Results:

Among in-house occupational health services, the most highly ranked difficulties were case management of workers with limitations and the low quality of medical surveillance systems. Among outsourced occupational health services, the most notable difficulties were the lack of communication with other organizations and the prioritization of economic and profitability criteria associated with the high work volume. For both types of services, there was a clear need to establish communication channels with other institutions or organizations such as primary care, mutual insurance companies, public medical evaluation units and public occupational health units.

Conclusions:

The different type of occupational health services reflects important differences in the types of difficulties encountered, but not in needs, where there are more points in common.

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