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BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-12-2015 | Research article

Problems with sickness certification tasks: experiences from physicians in different clinical settings. A cross-sectional nationwide study in Sweden

Authors: Therese Ljungquist, Elin Hinas, Gunnar H. Nilsson, Catharina Gustavsson, Britt Arrelöv, Kristina Alexanderson

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

Many physicians find sickness certification of patients problematic. The aims were to explore problems that physicians in different clinical settings experience with sickness certification tasks in general and with assessment of function, work capacity, and need for sick leave, as well as handling of sick-leave spells of different durations.

Methods

Data from a questionnaire sent to 33 144 physicians aged <68 years, living and working in Sweden in 2012 were analysed. The response rate was 57.6 %. The study group comprised the 12 933 responders who had sickness certification tasks. Frequencies and odds ratios with 95 % confidence intervals were calculated for questions concerning how problematic the physicians experienced different assessments related to patients’ function, work capacity, and need for sick leave, as well as handling sick-leave spells of different durations.

Results

There were large differences between clinical settings regarding how often and to what extent sickness certification consultations were perceived as problematic. Physicians working in primary health care (PHC) had the highest proportions experiencing sickness certification consultations as problematic at least once a week (49.5 %) and as very or fairly problematic (56.6 %), followed by physicians working in psychiatry, pain management, or orthopaedics. More than half of the responders found it very or fairly problematic to assess patients’ work capacity (57.8 %), to make a long-term prognosis about patients’ future work capacity (55.7 %), and to handle long-term or very long-term sickness certifications (51.9 % and 51.8 %). The proportions were highest among physicians working in PHC, rheumatology, neurology, or psychiatry.

Conclusions

The rates of physicians finding sickness certification task problematic varied much with clinical setting, and were highest among physicians in PHC. More knowledge is needed about the work conditions and prerequisites for optimal handling of sickness certification in different clinical settings.
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Metadata
Title
Problems with sickness certification tasks: experiences from physicians in different clinical settings. A cross-sectional nationwide study in Sweden
Authors
Therese Ljungquist
Elin Hinas
Gunnar H. Nilsson
Catharina Gustavsson
Britt Arrelöv
Kristina Alexanderson
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-0937-6

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