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BMC Primary Care
Published in: BMC Primary Care 1/2008

Open Access 01-12-2008 | Research article

How primary health care physicians make sick listing decisions: The impact of medical factors and functioning

Authors: Gunilla Norrmén, Kurt Svärdsudd, Dan KG Andersson

Published in: BMC Primary Care | Issue 1/2008

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Abstract

Background

The decision to issue sickness certification in Sweden for a patient should be based on the physician's assessment of the reduction of the patient's work capacity due to a disease or injury, not on psychosocial factors, in spite of the fact that they are known as risk factors for sickness absence. The aim of this study was to investigate the influence of medical factors and functioning on sick listing probability.

Methods

Four hundred and seventy-four patient-physician consultations, where sick listing could be an option, in general practice in Örebro county, central Sweden, were documented using physician and patient questionnaires. Information sought was the physicians' assessments of causes and consequences of the patients' complaints, potential to recover, diagnoses and prescriptions on sick leave, and the patients' view of their family and work situation and functioning as well as data on the patients' former and present health situation. The outcome measure was whether or not a sickness certificate was issued. Multivariate analyses were performed.

Results

Complaints entirely or mainly somatic as assessed by the physician decreased the risk of sick listing, and complaints resulting in severe limitation of occupational work capacity, as assessed by the patient as well as the physician, increased the risk of sick listing, as did appointments for locomotor complaints. The results for patients with infectious diseases or musculoskeletal diseases were partly similar to those for all diseases.

Conclusion

The strongest predictors for sickness certification were patient's and GP's assessment of reduced work capacity, with a striking concordance between physician and patient on this assessment. When patient's complaints were judged to be non-somatic the risk of sickness certification was enhanced.
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Metadata
Title
How primary health care physicians make sick listing decisions: The impact of medical factors and functioning
Authors
Gunilla Norrmén
Kurt Svärdsudd
Dan KG Andersson
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2008
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-9-3

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