Document Detail

Patient, clinician, and general practice factors in long-term certified sickness.
MedLine Citation:
PMID:  17530546     Owner:  NLM     Status:  MEDLINE    
AIMS: To investigate the association of patient, clinician, and general practice factors with long-term certified sickness absence. METHODS: Analysis of a sickness certification database constructed via the use of carbonized sick notes by clinicians at nine general practices in the north-west of England. A total of 3,385 patient sickness episodes certified by 44 general practitioners (GPs) were included in the analysis. Three logistic regression models were constructed in order to estimate independent effects of the patient, GP, and the general practice on risk of long-term (>28 weeks) incapacity. RESULTS: The logistic regression models explained a maximum of 27% of the variation in long-term certified sickness. The diagnostic reason for the sickness episode explained over 18% of variance, while clinician and general practice effects explained only 3.4% and 2.3% respectively. In all models, older patient age and an episode within the mild mental disorder (MMD) diagnostic category significantly increased the risk of long-term work incapacity. CONCLUSIONS: The study results imply that, rather than basing 'return to work' interventions on identification of individual patient/claimant characteristics or on GP training initiatives, it may be more productive to focus upon a more diagnosis-based approach within primary care itself. Interventions aiming to reduce mild mental disorder-related work incapacity should be given priority.
Christopher Shiels; Mark B Gabbay
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of public health     Volume:  35     ISSN:  1403-4948     ISO Abbreviation:  Scand J Public Health     Publication Date:  2007  
Date Detail:
Created Date:  2007-05-28     Completed Date:  2007-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883503     Medline TA:  Scand J Public Health     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  250-6     Citation Subset:  IM    
Mersey Primary Care R&D Consortium, UK.
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MeSH Terms
Disability Evaluation*
Family Practice*
Mental Disorders / diagnosis
Physician's Role
Rehabilitation, Vocational
Sick Leave*
Time Factors
Work Capacity Evaluation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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