Explaining variations in general practitioners’ experiences of doing medically based assessments of work ability in disability benefit claims. A survey-based analysis

Roland Mandal,Karin Dyrstad,Albert Lee

doi:10.1080/2331205x.2017.1368614

Abstract

AbstractPurpose: Assessing patients’ work ability is a task that many general practitioners consider challenging. Increase of mental and musculoskeletal disorders further complicate the assessments. The purpose of this paper is to explain variation between general practitioners related to how they experience the assessment of work ability in disability cases. Methods: Combining data from an original postal survey among all general practitioners in Norway (N = 1,466; response rate = 32.5%) with characteristics of the municipality where they work, we use multilevel logistic regression to estimate the relationship between a set of dependent variables measuring how confident general practitioners feel when assessing patients’ work ability in disability cases, physician-related characteristics and structural factors. Results: A main finding is that length of service explains most of the variation between general practitioners (B = 0.492 [0.015, 0.970]–2.127 [1.457, 2.798]); in most of the regressions, this var...

Highlights

The proportion of working age people outside the labour market as recipients of disability benefits is high in Norway
The response rate among the General practitioners (GPs) vary little with municipality size, but it is lower among GPs working in the smallest municipalities
The analysis indicates that physician-related factors are more important than structural factors in explaining variations among GPs concerning their experiences with doing assessments of work ability

Summary

Introduction

The proportion of working age people outside the labour market as recipients of disability benefits is high in Norway. At the same time, ageing populations as well as future estimates of population development indicate a marked decrease in the share of the working age population in proportion to the total population in Western Europe (Colombo, Llena-Nozal, Mercier, & Tjadens, 2011). This development makes it increasingly important to increase the employment rate of those who do have a work ability, even if they are not able to have a fulltime job. GPs could be seen as suppliers of the medical information that founds the basis for the processing of applications for disability benefits (Brage, 2010; Pransky, Katz, Benjamin, & Himmelstein, 2002)

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Discussion

Conclusion