Influence on sickness certification of opinions and attitudes towards health related and insurance system related matters among general practitioners and their patients
(English)Manuscript (preprint) (Other academic)
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.
Sick leave, family medicine, primary care, sickness certification, attitude
Research subject Family Medicine
IdentifiersURN: urn:nbn:se:uu:diva-120556OAI: oai:DiVA.org:uu-120556DiVA: diva2:303568