Cooperation between gatekeepers in sickness insurance – the perspective of social insurance officers. A qualitative study

Thorstensson, Carina A; Mathiasson, Jenny; Arvidsson, Barbro; Heide, Anders; Petersson, Ingemar F

doi:10.1186/1472-6963-8-231

Cited by 16 publications

(26 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Satisfaction had been similarly high for some items (for example, 89% of appraisals with complete response to key questions), but long waiting times for every third appraisal had been criticized, as well. Studies from Scandinavia have also highlighted time consuming waiting times and partly insufficient content of certificates for the social insurance [8] or coordination problems between social insurance officers and assessors [9]. With our quantitative approach, we could confirm central findings of this valuable qualitative data for the Swiss setting.…”

Section: Discussionsupporting

confidence: 57%

Satisfaction of staff of Swiss insurance companies with medical appraisals: a cross sectional study

et al. 2011

View full text Add to dashboard Cite

BackgroundA high quality of timely delivered medical appraisals is crucial for social and other insurances to judge possible occupational reintegration measures for patients with medical conditions who are in danger to lose their job. However, little is known about the satisfaction of staff of insurance companies with medical appraisals that they have commissioned.Our questionnaire survey prospectively included all medical appraisals arriving at Swiss insurances from FEB to APR 2008. We assessed the satisfaction of the commissioner with medical appraisals performed by medical assessors. In addition, we evaluated the contribution of several factors to overall satisfaction. The unit of sample was the medical appraisal.FindingsWe analysed 3165 medical appraisals, 2444 (77%) of them from the public disability insurance, 678 (22%) from private accident, liability and loss of income insurances and 43 (1%) from other insurances. Overall satisfaction of staff of insurance companies in Switzerland was high, but satisfaction of the disability insurance with appraisals was generally lower compared to satisfaction of private insurances. The staff of the disability insurance judged time for preparation as too long in 30%. For staff of private insurance companies 20% of appraisals were not "worth its price". Well-grounded and comprehensible conclusions were the single most important factor for high overall satisfaction (OR 10.1; 95%-CI: 1.1-89.3).ConclusionsFrom the viewpoint of staff of insurance companies, a relevant part of medical appraisals arrives too late. Medical assessors have to take the specific needs of insurances into account, to perform more appraisals with sound conclusions in due time.

show abstract

Section: Discussionsupporting

confidence: 57%

Satisfaction of staff of Swiss insurance companies with medical appraisals: a cross sectional study

et al. 2011

View full text Add to dashboard Cite

show abstract

“…The communication between the GPs and their patients has an important role in sickness certification, especially in cases involving doctor–patient conflicts 1 18 28. Furthermore, problems in the contact between the GPs and the SIOs have been reported,29 and SIOs have stressed the significance of mutual understanding in that context 30. Our results indicate that the new guidelines have already led to improvements of this.…”

Section: Discussionmentioning

confidence: 67%

Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden

et al. 2011

View full text Add to dashboard Cite

ObjectivesDiagnoses-specific sickness certification guidelines were recently introduced in Sweden. The aim of this study was to investigate to which extent general practitioners (GPs) used these guidelines and how useful they found them, 1 year after introduction.DesignA cross-sectional questionnaire study. A comprehensive questionnaire about sickness certification practices in 2008 was sent to all physicians living and working in Sweden (n=36 898, response rate 60.6%). In all, 19.7% (n=4394) of the responders worked as GPs.SettingPrimary healthcare in all Sweden.ParticipantsThe participating GPs who had consultations concerning sickness certification at least a few times a year (n=4278, 97%).Main outcome measuresDescriptive statistics and prevalence ratios for the 11 questionnaire items about the use and usefulness of the sickness certification guidelines.ResultsA majority (76.2%) of the GPs reported that they used the guidelines. In addition, 65.4% and 43.5% of those GPs reported that the guidelines had facilitated their contacts with patients and social insurance officers, respectively. The guidelines also helped nearly one-third (31.5%) of the GPs to develop their competence and improve the quality of their management of sickness certification consultations (33.5%). About half experienced some problems when using the guidelines and 43.7% wanted better competence in using them. A larger proportion of non-specialists and of GPs with fewer sickness certification consultations had benefitted from the guidelines.ConclusionsThe national sickness certification guidelines implemented in Sweden were widely used by GPs already a year after introduction. Also, the GPs consider the guidelines useful in several respects, for example, in patient contacts and for competence development.

show abstract

“…A lack of communication or an insufficient dialogue between the different actors is a barrier [53], which may lead to ambiguity regarding the different roles and responsibilities in the rehabilitation process [14, 26, 37]. In the absence of communication, the actors may also have different views on the aims and goals of the collaboration [40, 45].…”

Section: Resultsmentioning

confidence: 99%

Organizational approaches to collaboration in vocational rehabilitation − An international literature review

et al. 2011

View full text Add to dashboard Cite

show abstract

Cooperation between gatekeepers in sickness insurance – the perspective of social insurance officers. A qualitative study

Abstract: Background: Objective was to describe variations in how social insurance officers conceive the cooperation with the health care in their daily work with sick leave.

Cited by 16 publications

References 17 publications

Satisfaction of staff of Swiss insurance companies with medical appraisals: a cross sectional study

Satisfaction of staff of Swiss insurance companies with medical appraisals: a cross sectional study

Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden

Organizational approaches to collaboration in vocational rehabilitation − An international literature review

Contact Info

Product

Resources

About