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- Gustavsson, Catharina, 1961-, et al.
(author)
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General practitioners' use of sickness certification guidelines in Sweden at introduction and four years later : a survey study
- 2018
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In: International Journal for Quality in Health Care. - : OXFORD UNIV PRESS. - 1353-4505 .- 1464-3677. ; 30:6, s. 429-436
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Journal article (peer-reviewed)abstract
- Objective: National sickness certification guidelines were introduced in Sweden in 2007, comprising both overarching and diagnoses-specific recommendations. This study aimed to investigate how general practitioners (GP) used and perceived the usefulness of these guidelines in the sickness certification process close after introduction and 4 years later. Design: Two nationwide cross-sectional surveys in 2008 and 2012. Setting: Swedish healthcare. Participants: Physicians working in primary healthcare and having sickness certification consultations at least a few times per year (n = 4214 in 2008, and n = 4067 in 2012). Main Outcome Measures: Frequency of use and perceived usefulness of the sickness certification guidelines. Results: Most GPs used the guidelines at least a few times per year (in 2008 74.6%; in 2012 85.2%). In 2008, 44.1% reported a need to develop competence in using the guidelines, compared with 23.3% in 2012. Of those using the guidelines, 36.7% in 2008 and 44.6% in 2012 reported it problematic to write sickness certificates in accordance with the guidelines. Most GPs (89.2% in 2008 and 88.8% in 2012) valued the guidelines beneficial to ensure quality in sickness certification consultations. A larger proportion in 2012 compared with 2008 reported that the guidelines facilitated contacts with patients (61.2%, respectively, 55.6%), as well as with other stakeholders. Conclusions: The guidelines were perceived as useful and beneficial to ensure high quality in sickness certification consultations, and facilitated contacts with patients as well as other stakeholders. In 2012, still one-fourth reported a need to develop more competence in using the sickness certification guidelines.
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| 2. |
- Gustavsson, Catharina, et al.
(author)
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Obstetricians/Gynecologists' Problems in Sickness Certification Consultations : Two Nationwide Surveys.
- 2016
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In: Obstetrics and Gynecology International. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2016
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Journal article (peer-reviewed)abstract
- Although O/Gs perceived sickness certification as problematic, there was less perceived severity of problems in 2012 compared to 2008, possibly because interventions regarding sickness certification have been introduced in Sweden recent years. Still, more organizational support, for example, time and supervision, are needed to enhance O/Gs' sickness certification practices.
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| 4. |
- Ljungquist, Therese, et al.
(author)
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Problems with sickness certification tasks : experiences from physicians in different clinical settings. A cross-sectional nationwide study in Sweden.
- 2015
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In: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 15
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Journal article (peer-reviewed)abstract
- BACKGROUND: Many physicians find sickness certification of patients problematic. The aims were to explore problems that physicians in different clinical settings experience with sickness certification tasks in general and with assessment of function, work capacity, and need for sick leave, as well as handling of sick-leave spells of different durations.METHODS: Data from a questionnaire sent to 33,144 physicians aged <68 years, living and working in Sweden in 2012 were analysed. The response rate was 57.6%. The study group comprised the 12,933 responders who had sickness certification tasks. Frequencies and odds ratios with 95% confidence intervals were calculated for questions concerning how problematic the physicians experienced different assessments related to patients' function, work capacity, and need for sick leave, as well as handling sick-leave spells of different durations.RESULTS: There were large differences between clinical settings regarding how often and to what extent sickness certification consultations were perceived as problematic. Physicians working in primary health care (PHC) had the highest proportions experiencing sickness certification consultations as problematic at least once a week (49.5%) and as very or fairly problematic (56.6%), followed by physicians working in psychiatry, pain management, or orthopaedics. More than half of the responders found it very or fairly problematic to assess patients' work capacity (57.8%), to make a long-term prognosis about patients' future work capacity (55.7%), and to handle long-term or very long-term sickness certifications (51.9% and 51.8%). The proportions were highest among physicians working in PHC, rheumatology, neurology, or psychiatry.CONCLUSIONS: The rates of physicians finding sickness certification task problematic varied much with clinical setting, and were highest among physicians in PHC. More knowledge is needed about the work conditions and prerequisites for optimal handling of sickness certification in different clinical settings.
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| 5. |
- Snöljung, Åsa, et al.
(author)
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Neurologists dealing with sickness certification : Experiences of problems and need of competence
- 2017
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In: Brain and Behavior. - : WILEY. - 2162-3279 .- 2162-3279. ; 7:11
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Journal article (peer-reviewed)abstract
- Rationale and AimsMost studies on physicians' sickness certification practices include general practitioners (GP) while there hardly is any knowledge on this regarding neurologists although neurological diseases often involve work incapacity and need of sick leave. AimThe aim was to describe experiences among neurologists in Sweden concerning their work with sickness certification of patients. MethodA cross-sectional study of 265 neurologists' responses in a nationwide survey regarding their work with sickness certification of patients was conducted. ResultsThe majority (81.5%) had sickness certification consultations at least once a week and a third experienced problems every week in handling sickness certification. Among the 251 who at least sometimes had sickness certification consultations, the following two aspects were experienced as very or fairly problematic: assess the degree to which the reduced functional capacity limits a patient's capacity to perform his/her work assignments (67.3%) and make a long-term prognosis about the future work capacity of patients on sick leave (60.5%). At least once a week, 78.7% experienced lack of time regarding managing patient-related aspects of the sickness certification task. Moreover, 21.8% considered sickness certification to be a work environmental problem, at least once a week. In all, 84% stated that they had a large or fairly large need for more competence concerning sickness certification tasks. ConclusionsSickness certification is a common task among neurologists, involving several problematic aspects related to, e.g., lack of competence in assessing function and work capacity and of time. There is a need for improvement.
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