[Occupational medicine and quality].

The discipline of occupational medicine has always maintained a closed relationship with the quality system, starting from the well known quality assurance practices, up to the quality of health services, and the concept of prevention and health promotion as essential components of quality programs. The quality of health care has emerged as an area of high interest and concern, driven by the consideration of public policy and the desire of health care government to maximize the value of their investments. However, when we move to apply quality principles to health service some difficulties emerge. For example the introduction of DRFs system makes uneconomical the diagnosis in occupational medicine, since the costs are determined by the type and the number of hazards to be identified and assessed and not only by the risk factors of by the worker's pathology. Moreover, resources are necessary for the correct evaluation of non occupational pathologies often present, both for deontological and legal reasons. The attention to the role of occupational medicine in quality programs has been increased by the recognition of the adverse impact of preventable or controllable risk factors in health benefit and disability costs and employee productivity. By this way prevention and health promotion will become an essential part of quality procedures able to guarantee and maintain quality objectives.