uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Influence on sickness certification of opinions and attitudes towards health related and insurance system related matters among general practitioners and their patients
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Aim: The aim of this study was to evaluate the influence of patients’ and physicians’ opinions and attitudes towards health related and insurance system related matters on sickness certification in primary health care.

Methods: 474 patient-physician consultations in general practice in Örebro county, central Sweden, in which sickness certification was an option were documented using physician and patient questionnaires. The outcome measure was whether or not a sickness certificate was issued. Possible determinants were variables indicating the patient’s and the physician’s extent of agreement with statements concerning health and social insurance matters.

Results: GPs and their patients took a fairly similar view to the statements. After multivariate analysis, attitudes expressed by the GPs’ were significantly more frequently related to their decision to sick certify or not, than were patients’ attitudes on the same items. The variables with the strongest impact were found when GPs expressed confidence in physicians’ knowledge of working life and when patients’ gave credit to employers’ willingness to keep disabled people in work. Such attitudes were in general associated with less sickness certification. Patients with musculoskeletal diseases, having met a GP who meant that patients should be allowed sick leave when not mentally well, were more often sick certified.

Conclusions: Opinions among GPs and patients influence on sickness certification risk in several ways. GPs’ opinions seem to have a greater impact than patients’ on the GPs’ decision to sick certify a patient or not.

Keyword [en]
Sick leave, family medicine, primary care, sickness certification, attitude
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
URN: urn:nbn:se:uu:diva-120556OAI: oai:DiVA.org:uu-120556DiVA: diva2:303568
Projects
Försäkringsmedicin
Available from: 2010-03-13 Created: 2010-03-13 Last updated: 2010-03-14
In thesis
1. To be or not to be Sick Certified with Special Reference to Physician and Patient Related Factors
Open this publication in new window or tab >>To be or not to be Sick Certified with Special Reference to Physician and Patient Related Factors
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objectives The aim of this thesis was to assess the importance of general practitioners (GP) and patient related factors for the GPs’ decision to sick certify or not to sick certify the patients.

Study population and methods The data were obtained from a cross-sectional questionnaire study of GP-patient consultations. 65 GPs responded to one questionnaire about themselves and one questionnaire about each of the altogether 642 consultations. The patients responded to a questionnaire about themselves and the consultation, altogether 521 consultations. Various combinations of the three questionnaires were used in the four papers on which this thesis is based.

Results Among GPs, long experience of family medicine and working part-time were significant determinants for issuing more sick leave certificates. Complaints perceived as clearly somatic by the physician decreased the chance of sick certifications, and complaints resulting in severe limitation of occupational work capacity, as assessed by the patient as well as the physician, increased the chance of sick certification, as did appointments for loco-motor complaints. Among work related factors, high ‘authority over decisions’ and high ‘social support’ were associated with reduced sickness certification probability. Worrying about illness or injury risks from work increased sickness certification. GPs and their patients took a fairly similar view to statements on health related and insurance system related matters. GPs’ opinions seem to have a greater impact than patients’ on the GPs’ decision to sickness certify a patient or not.

Conclusions A number of patient and GP related factors were associated with the probability of getting sick certified. The patient’s own judgement of impaired work ability was important for sickness certification, but a shared judgement and decision between the GP and the patient appears probable in most cases.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 80 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 535
Keyword
sick leave, absenteeism, primary care, family medicine, consultation, professional competence, work capacity, work strain, work demands, authority over decisions, social support, attitude.
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
urn:nbn:se:uu:diva-120559 (URN)978-91-554-7747-9 (ISBN)
Public defence
2010-05-03, Wilandersalen, M-huset, Universitetssjukhuset, Örebro, 13:15 (Swedish)
Opponent
Supervisors
Projects
Försäkringsmedicin
Available from: 2010-04-09 Created: 2010-03-14 Last updated: 2010-04-09Bibliographically approved

Open Access in DiVA

No full text

Authority records BETA

Svärdsudd, Kurt

Search in DiVA

By author/editor
Svärdsudd, Kurt
By organisation
Family Medicine and Clinical Epidemiology
Family Medicine

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 410 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf