Sick-leave decisions for patients with severe subjective health complaints presenting in primary care: A cross-sectional study in Norway, Sweden, and Denmark

• Published in: Scandinavian journal of primary health care Vol. 31; no. 4; pp. 227 - 234
• Main Authors: Maeland, Silje, Werner, Erik L., Rosendal, Marianne, Jonsdottir, Ingibjorg H., Magnussen, Liv H., Lie, Stein Atle, Ursin, Holger, Eriksen, Hege R.
• Format: Journal Article
• Language: English
• Published: United States Informa Healthcare 01.12.2013; Taylor & Francis; Taylor & Francis LLC
• Subjects: Adult; Complaints; Cross-Sectional Studies; Decision Making; Denmark; Deterioration; Diagnosis; Diagnostic Self Evaluation; Family physicians; family practice; Female; general practice; General practitioners; General Practitioners - psychology; General Practitioners - statistics & numerical data; Humans; Male; medically unexplained symptoms; Mental Disorders - diagnosis; Mental health; Middle Aged; Norway; Original; Patients; Practice Patterns, Physicians' - statistics & numerical data; Primary care; Primary Health Care; Severity of Illness Index; Sick leave; Sick Leave - statistics & numerical data; Size of enterprise; somatoform disorder; Specialists; Sweden; Vignettes; Work Capacity Evaluation; Denmark; Norway; Sweden
• ISSN: 0281-3432; 1502-7724; 1502-7724
• DOI: 10.3109/02813432.2013.844412

Abstract Objectives. The primary objective of this study was to explore whether general practitioners (GPs) in Norway, Sweden, and Denmark make similar or different decisions regarding sick leave for patients with severe subjective health complaints (SHC). The secondary objective was to investigate if patient diagnoses, the reasons attributed for patient complaints, and GP demographics could explain variations in sick leave decisions. Design. A cross-sectional study. Method. Video vignettes of GP consultations with nine different patients. Subjects. 126 GPs in Norway, Sweden, and Denmark. Setting. Primary care in Norway, Sweden, and Denmark. Main outcome measure. Sick leave decisions made by GPs. Results. "Psychological" diagnoses in Sweden were related to lower odds ratio (OR) of granting sick leave than in Norway (OR = 0.07; 95% CI = 0.01-0.83) Assessments of patient health, the risk of deterioration, and their ability to work predicted sick leave decisions. Specialists in general medicine grant significantly fewer sick leaves than non-specialists. Conclusion. Sick-leave decisions made by GPs in the three countries were relatively similar. However, Swedish GPs were more reluctant to grant sick leave for patients with "psychological" diagnoses. Assessments regarding health-related factors were more important than diagnoses in sick-leave decisions. Specialist training may be of importance for sick-leave decisions.