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Sickness-certification practice in different clinical settings; a survey of all physicians in a country

BACKGROUND: How physicians handle sickness-certification is essential in the sickness-absence process. Few studies have focused this task of physicians' daily work. Most previous studies have only included general practitioners. However, a previous study indicated that this is a common task als...

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Autores principales: Lindholm, Christina, Arrelöv, Britt, Nilsson, Gunnar, Löfgren, Anna, Hinas, Elin, Skånér, Ylva, Ekmer, Anna, Alexanderson, Kristina
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016384/
https://www.ncbi.nlm.nih.gov/pubmed/21129227
http://dx.doi.org/10.1186/1471-2458-10-752
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author Lindholm, Christina
Arrelöv, Britt
Nilsson, Gunnar
Löfgren, Anna
Hinas, Elin
Skånér, Ylva
Ekmer, Anna
Alexanderson, Kristina
author_facet Lindholm, Christina
Arrelöv, Britt
Nilsson, Gunnar
Löfgren, Anna
Hinas, Elin
Skånér, Ylva
Ekmer, Anna
Alexanderson, Kristina
author_sort Lindholm, Christina
collection PubMed
description BACKGROUND: How physicians handle sickness-certification is essential in the sickness-absence process. Few studies have focused this task of physicians' daily work. Most previous studies have only included general practitioners. However, a previous study indicated that this is a common task also among other physicians. The aim of this study was to gain detailed knowledge about physicians' work with sickness-certification and of the problems they experience in this work. METHODS: A comprehensive questionnaire regarding sickness-certification practice was sent home to all physicians living and working in Sweden (N = 36,898; response rate: 61%). This study included physicians aged <65 years who had sickness-certification consultations at least a few times a year (n = 14,210). Descriptive statistics were calculated and odds ratios (OR) with 95 % confidence intervals (CI) were estimated for having different types of related problems, stratified on clinical settings, using physicians working in internal medicine as reference group. RESULTS: Sickness-certification consultations were frequent; 67% of all physicians had such, and of those, 83% had that at least once a week. The proportion who had such consultations >5 times a week varied between clinical settings; from 3% in dermatology to 79% in orthopaedics; and was 43% in primary health care. The OR for finding sickness-certification tasks problematic was highest among the physicians working in primary health care (OR 3.3; CI 2.9-3.7) and rheumatology clinics (OR 2.6; CI 1.9-3.5). About 60% found it problematic to assess patients' work capacity and to provide a prognosis regarding the duration of work incapacity. CONCLUSIONS: So far, most interventions regarding physicians' sickness-certification practices have been targeted towards primary health care and general practitioners. Our results indicate that the ORs for finding these tasks problematic were highest in primary health care. Nevertheless, physicians in some other clinical settings more often have such consultations and many of them also find these tasks problematic, e.g. in rheumatology, neurology, psychiatry, and orthopaedic clinics. Thus, the results indicate that much can be gained through focusing on physicians in other types of clinics as well, when planning interventions to improve sickness-certification practice.
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spelling pubmed-30163842011-01-06 Sickness-certification practice in different clinical settings; a survey of all physicians in a country Lindholm, Christina Arrelöv, Britt Nilsson, Gunnar Löfgren, Anna Hinas, Elin Skånér, Ylva Ekmer, Anna Alexanderson, Kristina BMC Public Health Research Article BACKGROUND: How physicians handle sickness-certification is essential in the sickness-absence process. Few studies have focused this task of physicians' daily work. Most previous studies have only included general practitioners. However, a previous study indicated that this is a common task also among other physicians. The aim of this study was to gain detailed knowledge about physicians' work with sickness-certification and of the problems they experience in this work. METHODS: A comprehensive questionnaire regarding sickness-certification practice was sent home to all physicians living and working in Sweden (N = 36,898; response rate: 61%). This study included physicians aged <65 years who had sickness-certification consultations at least a few times a year (n = 14,210). Descriptive statistics were calculated and odds ratios (OR) with 95 % confidence intervals (CI) were estimated for having different types of related problems, stratified on clinical settings, using physicians working in internal medicine as reference group. RESULTS: Sickness-certification consultations were frequent; 67% of all physicians had such, and of those, 83% had that at least once a week. The proportion who had such consultations >5 times a week varied between clinical settings; from 3% in dermatology to 79% in orthopaedics; and was 43% in primary health care. The OR for finding sickness-certification tasks problematic was highest among the physicians working in primary health care (OR 3.3; CI 2.9-3.7) and rheumatology clinics (OR 2.6; CI 1.9-3.5). About 60% found it problematic to assess patients' work capacity and to provide a prognosis regarding the duration of work incapacity. CONCLUSIONS: So far, most interventions regarding physicians' sickness-certification practices have been targeted towards primary health care and general practitioners. Our results indicate that the ORs for finding these tasks problematic were highest in primary health care. Nevertheless, physicians in some other clinical settings more often have such consultations and many of them also find these tasks problematic, e.g. in rheumatology, neurology, psychiatry, and orthopaedic clinics. Thus, the results indicate that much can be gained through focusing on physicians in other types of clinics as well, when planning interventions to improve sickness-certification practice. BioMed Central 2010-12-06 /pmc/articles/PMC3016384/ /pubmed/21129227 http://dx.doi.org/10.1186/1471-2458-10-752 Text en Copyright ©2010 Lindholm et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<url>http://creativecommons.org/licenses/by/2.0</url>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Lindholm, Christina
Arrelöv, Britt
Nilsson, Gunnar
Löfgren, Anna
Hinas, Elin
Skånér, Ylva
Ekmer, Anna
Alexanderson, Kristina
Sickness-certification practice in different clinical settings; a survey of all physicians in a country
title Sickness-certification practice in different clinical settings; a survey of all physicians in a country
title_full Sickness-certification practice in different clinical settings; a survey of all physicians in a country
title_fullStr Sickness-certification practice in different clinical settings; a survey of all physicians in a country
title_full_unstemmed Sickness-certification practice in different clinical settings; a survey of all physicians in a country
title_short Sickness-certification practice in different clinical settings; a survey of all physicians in a country
title_sort sickness-certification practice in different clinical settings; a survey of all physicians in a country
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016384/
https://www.ncbi.nlm.nih.gov/pubmed/21129227
http://dx.doi.org/10.1186/1471-2458-10-752
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