Abstract
BackgroundThe decision to issue sickness certification in Sweden for a patient should be based on the physician's assessment of the reduction of the patient's work capacity due to a disease or injury, not on psychosocial factors, in spite of the fact that they are known as risk factors for sickness absence. The aim of this study was to investigate the influence of medical factors and functioning on sick listing probability.MethodsFour hundred and seventy-four patient-physician consultations, where sick listing could be an option, in general practice in Örebro county, central Sweden, were documented using physician and patient questionnaires. Information sought was the physicians' assessments of causes and consequences of the patients' complaints, potential to recover, diagnoses and prescriptions on sick leave, and the patients' view of their family and work situation and functioning as well as data on the patients' former and present health situation. The outcome measure was whether or not a sickness certificate was issued. Multivariate analyses were performed.ResultsComplaints entirely or mainly somatic as assessed by the physician decreased the risk of sick listing, and complaints resulting in severe limitation of occupational work capacity, as assessed by the patient as well as the physician, increased the risk of sick listing, as did appointments for locomotor complaints. The results for patients with infectious diseases or musculoskeletal diseases were partly similar to those for all diseases.ConclusionThe strongest predictors for sickness certification were patient's and GP's assessment of reduced work capacity, with a striking concordance between physician and patient on this assessment. When patient's complaints were judged to be non-somatic the risk of sickness certification was enhanced.
Highlights
The decision to issue sickness certification in Sweden for a patient should be based on the physician's assessment of the reduction of the patient's work capacity due to a disease or injury, not on psychosocial factors, in spite of the fact that they are known as risk factors for sickness absence
Sickness certification in Sweden should be based on the physician's assessment of a patient having an impaired work capacity owing to disease or injury [1]
For all diagnoses we found strong evidence that limited capacity to work, assessed by the patient as well as by the GP, was the most important factor when sickness certification was issued
Summary
The decision to issue sickness certification in Sweden for a patient should be based on the physician's assessment of the reduction of the patient's work capacity due to a disease or injury, not on psychosocial factors, in spite of the fact that they are known as risk factors for sickness absence. Sickness certification in Sweden should be based on the physician's assessment of a patient having an impaired work capacity owing to disease or injury [1]. BMC Family Practice 2008, 9:3 http://www.biomedcentral.com/1471-2296/9/3 but provide no definition of disease [2]. This leaves room for individual assessments among doctors and patients on the issue of sick listing and being sick listed. On the one hand they must do their utmost to maintain a good doctor-patient relationship, on the other hand they have to comply with the demands of society and refrain from the overuse of public resources
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call