Sickness certification in primary care

DüNNER, Sébastien; Decrey, H; Burnand, Bernard; Pécoud, A

doi:10.1007/bf01321665

Cited by 26 publications

(7 citation statements)

References 19 publications

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“…In terms of the impact of family circumstances, although the GPs felt more sympathy for the patient with the adverse family circumstances they were no more likely to issue him with a sickness certificate, despite the considerable literature suggesting that GPs are influenced by a patient's social and economic circumstances (1,8,15). It may be that doctors' decisions are determined more by factors that obviously impact on fitness for work, such as age and skills, or availability of work and the scenarios did not give sufficient information about such factors, or it may be that they felt that given his difficult home circumstances Mr X was better off at work.…”

Section: Discussionmentioning

confidence: 99%

Why do doctors issue sick notes? An experimental questionnaire study in primary care

Campbell¹,

Ogden²

2005

Family Practice

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Section: Discussionmentioning

confidence: 99%

Why do doctors issue sick notes? An experimental questionnaire study in primary care

Campbell¹,

Ogden²

2005

Family Practice

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“…The literature presents evidence of no difference in certification by sex, but there is some increase in duration with increasing age. 17,[19][20][21] There is also evidence that duration of certification is associated with condition; in particular, musculoskeletal and mental health conditions have longer certified absences. 19,21 The lack of information on duration in this paper could mean that total length of certification for musculoskeletal and mental health conditions is actually higher than indicated by the rates reported here, as not only are the rates higher but the duration could also be longer.…”

Section: Strengths and Limitations Of The Studymentioning

confidence: 99%

Identification of UK sickness certification rates, standardised for age and sex

et al. 2009

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BackgroundThere is growing interest in tackling the perceived 'sick note' culture in the UK. AimThe aim of this paper was to report the rates of sickness certification in a UK population, using sick certification rates as a precursor to addressing fitness for work. MethodElectronic records from all 14 practices included in the Keele GP Research Network were reviewed; all sickness certification records from 2005 were retrieved and corresponding consultation records were examined. Participants were 148 176 patients registered during 2005, including 6398 patients who received at least one sickness certificate during the same year. ResultsThe rate of sickness certification was 101.67 certificates per 1000 person years (95% confidence interval [CI] = 100.13 to 103.21). This rate was significantly higher in women, at 109.76 certificates per 1000 person years (95% CI = 107.550 to 112.02), compared to men who had a rate of 93.68 certificates per 1000 person years (95% CI = 91.59 to 95.78; P<0.001). The rate of sickness certification was greatest for mental health conditions, followed closely by musculoskeletal conditions. ConclusionOn average, one in 10 patients will receive a sickness certificate each year, with the highest rates occurring around 50 years of age, in women. Mental health and musculoskeletal conditions were associated with the highest rates of certification. These results provide important information to underpin the national 'Fit for Work' scheme, by providing targets for intervention and a benchmark against which the impact of public health initiatives to reduce certified sickness absence due to health conditions can be evaluated and monitored.

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“…5 5 The argument that medical information is not sufficient or adequate to assess incapacity is also discussed in sickness‐certifying literature. See for instance Tellnes 1989, De Boer 1992, Reiso et al 2000, Dünner et al 2001, Söderberg and Alexanderson 2003. …”

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confidence: 99%

Judging without criteria? Sickness certification in Dutch disability schemes

Meershoek

Krumeich

Vos

2007

Sociology Health & Illness

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The gate-keeping function that physicians perform in determining clients' physical and mental incapacities is widely assumed to be the main reason for the rising numbers of disabled people. The sharp rise in the number of disabled has led many to claim that the disability benefits schemes are untenable. In order to regain public control and to make disabled eligibility procedures more transparent guidelines have been introduced in which medical evaluations are conceptualised as formal rational decisions. It is, however, questionable whether such measures are helpful in achieving their stated aims. This paper is based on ethnographic research on the ways physicians evaluate the eligibility of clients for disability benefits. It argues that assessing incapacity involves much more than formal rational decision-making. Doctors' reasoning is contextual and deliberative in character, and thus their assessment of a client's incapacity is less a technical matter than a normative one. Instead of generating transparency, guidelines based on formal rationality make the complex deliberations on which such judgments are based invisible, because they deny the normative dimension of medical expert decision-making. Therefore, different measures have to be developed that allow this normative dimension to be articulated, since insight into this normative dimension is a necessary pre-condition to be able to criticise disability judgments at all.

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Sickness certification in primary care

Cited by 26 publications

References 19 publications

Why do doctors issue sick notes? An experimental questionnaire study in primary care

Why do doctors issue sick notes? An experimental questionnaire study in primary care

Identification of UK sickness certification rates, standardised for age and sex

Judging without criteria? Sickness certification in Dutch disability schemes

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