General practitioner characteristics and sickness absence—a register-based study of 348 054 employed Norwegians

Abstract

Background: Sickness certification is currently of increased interest in general practice research. Sickness absence certification is a key medical task for general practitioners (GPs), but the knowledge of GPs’ certification practices and the GPs’ role in sickness absence is limited and partly contradictory. Objective: The objective of this study was to analyse whether rates of sickness absence vary in relation to characteristics of the GP and their list-population. Methods: The data set consisted of matched GP–patient data, including 627 GPs and 348 054 people in employment in the two largest cities in Norway in 2006. Sickness absence rates (total annual days) were estimated using descriptive statistics and analysis of variation. Results: Of the population at risk of sick leave, 23.3% of the women had at least one sickness episode in 2006, compared with 12.7% of the men. Mean total annual days of sick leave was 12.1 for the women and 6.4 for the men. Characteristics of the GPs’ list population, especially the socio-economic status of those on the list, were associated with variations in sickness absence rates. GP gender and age showed association only in one subgroup of list patients.Conclusion: Our findings support previous studies concluding that individual patient factors are the most important variables explaining with sickness absence patterns. The study also showed that some GP-factors, and especially factors linked to the composition of the list population, are associated with variations in sickness absence rates and thus important when studying certification practices.