Dataset Information

Psychiatrists' work with sickness certification: frequency, experiences and severity of the certification tasks in a national survey in Sweden.

ABSTRACT: Many psychiatrists are involved in sickness certification of their patients; however, there is very limited knowledge about this aspect of their work. The objective of this study was to explore frequencies of problematic issues in the sickness certification tasks and experiences of severity regarding these problematic issues among psychiatrists.A cross-sectional nationwide questionnaire study to all physicians in Sweden. The 579 specialists in psychiatry who answered the questionnaire, were under 65 years of age, worked mainly in psychiatric care, and had consultations involving sickness certification at least once a week were included.The frequency of problematic sickness certification consultations a few times per year or more often was considered by 87.3% of the psychiatrists; 11.7% handle such cases at least once a week. A majority (60.9%) reported 'not having enough time with the patient' at least once a week. The psychiatrists had access to several categories of professionals in their daily work. More than one third certified unnecessarily long sick-leave periods at least once a month due to waiting times for Social Insurance Office investigations or for treatments or investigations within health care.The majority found it problematic to assess the level and duration of work incapacity, but also other types of problems like unnecessarily long sick-leave periods due to different types of waiting times. The findings have implications for different kinds of organisational and managerial support and training in sickness certification issues, like guidance to assess the level and duration of work incapacity.

SUBMITTER: Nilsson GH

PROVIDER: S-EPMC3480832 | biostudies-other | 2012 Oct

REPOSITORIES: biostudies-other

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Psychiatrists' work with sickness certification: frequency, experiences and severity of the certification tasks in a national survey in Sweden.

Nilsson Gunnar H GH Arrelöv Britt B Lindholm Christina C Ljungquist Therese T Kjeldgård Linnea L Alexanderson Kristina K

BMC health services research 20121017

<h4>Background</h4>Many psychiatrists are involved in sickness certification of their patients; however, there is very limited knowledge about this aspect of their work. The objective of this study was to explore frequencies of problematic issues in the sickness certification tasks and experiences of severity regarding these problematic issues among psychiatrists.<h4>Methods</h4>A cross-sectional nationwide questionnaire study to all physicians in Sweden. The 579 specialists in psychiatry who an ...[more]

PMID: 23075202

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Project description:ObjectivesTo explore physicians' experiences of using the national sickness certification guidelines introduced in 2007 and the types of information they used, in general and in different types of clinics.DesignCross-sectional survey.SettingMost physicians working in Sweden in 2017.ParticipantsA questionnaire was sent to 34 718 physicians; 54% responded. Analyses were based on answers from the 13 750 physicians who had sick leave cases.Outcome measuresTo what extent the guidelines were used and what type of information from them that was used.ResultsTen years after the sickness certification guidelines were introduced in Sweden, half of the physicians used them at least once a month. About 40% of physicians in primary healthcare and occupational health services used the guidelines every week. The type of information used varied; 53% used recommendations about duration and 29% about degree of sick leave. Using information about function and activity/work capacity, respectively, was more common within primary healthcare (37% and 38%), psychiatry (42% and 42%), and occupational health services (35% and 41%), and less common in surgery and orthopaedic clinics (12% and 12%) who more often used information about duration (48% and 53%). Moreover, 10% stated that the guidelines were very, and 24% fairly problematic to apply. Half (47%) stated that the guidelines facilitated their contacts with patients and 29% that they improved quality in their management of sick leave cases. More non-specialists, compared with specialists, found that the guidelines facilitated contacts with patients (OR 3.28, 95% CI 3.04 to 3.55).ConclusionsThe majority of the physicians used the sickness certification guidelines, although this varied with type of clinic. Half stated that the guidelines facilitated patient contacts. Yet, some found it problematic to apply the guidelines. Further development of the guidelines is warranted as well as more knowledge about them among physicians.

Project description:BACKGROUND:Internationally, there is a movement toward providing patients a Web-based access to their electronic health records (EHRs). In Sweden, Region Uppsala was the first to introduce patient-accessible EHRs (PAEHRs) in 2012. By the summer of 2016, 17 of 21 county councils had given citizens Web-based access to their medical information. Studies on the effect of PAEHRs on the work environment of health care professionals have been conducted, but up until now, few extensive studies have been conducted regarding patients' experiences of using PAEHRs in Sweden or Europe, more generally. OBJECTIVE:The objective of our study was to investigate patients' experiences of accessing their EHRs through the Swedish national patient portal. In this study, we have focused on describing user characteristics, usage, and attitudes toward the system. METHODS:A national patient survey was designed, based on previous interview and survey studies with patients and health care professionals. Data were collected during a 5-month period in 2016. The survey was made available through the PAEHR system, called Journalen, in Sweden. The total number of patients that logged in and could access the survey during the study period was 423,141. In addition to descriptive statistics reporting response frequencies on Likert scale questions, Mann-Whitney tests, Kruskal-Wallis tests, and chi-square tests were used to compare answers between different county councils as well as between respondents working in health care and all other respondents. RESULTS:Overall, 2587 users completed the survey with a response rate of 0.61% (2587/423,141). Two participants were excluded from the analysis because they had only received care in a county council that did not yet show any information in Journalen. The results showed that 62.97% (1629/2587) of respondents were women and 39.81% (1030/2587) were working or had been working in health care. In addition, 72.08% (1794/2489) of respondents used Journalen about once a month, and the main reason for use was to gain an overview of one's health status. Furthermore, respondents reported that lab results were the most important information for them to access; 68.41% (1737/2539) of respondents wanted access to new information within a day, and 96.58% (2454/2541) of users reported that they are positive toward Journalen. CONCLUSIONS:In this study, respondents provided several important reasons for why they use Journalen and why it is important for them to be able to access information in this way-several related to patient empowerment, involvement, and security. Considering the overall positive attitude, PAEHRs seem to fill important needs for patients.

Project description:OBJECTIVES:To identify new cases of musculoskeletal (MSK) disorders among employed people presenting in Norwegian primary care in 2012, frequency of sickness certification and length of sick leave. To identify patient-, diagnosis- and GP-related predictors of sickness certification, prolonged sick leave and return to work (RTW). METHODS:An observational multiregister-based cohort study covering all employed persons in Norway(1 176 681 women and 1 330 082 men) based on claims data from all regular GPs merged with individual sociodemographic data from public registers was performed. Participants were employed patients without any GP consultation during the previous 3?months who consulted a GP with a diagnosis of a MSK condition. Those not on sick leave and with a known GP affiliation were included in the analyses. Outcomes were incidence, proportion sickness certified and proportion on sick leave after 16 days, according to the diagnosis, ORs with 95% CIs for sickness certified and for sick leave exceeding 16 days and HRs with 95% CIs for RTW. RESULTS:One-year incidence of MSK episodes was 159/1000 among employed women and 156/1000 among employed men. 27.1% of the women and 28.2% of the men were sickness certified in the initial consultation. After 16 days, 10.5% of women and 9.9% of men were still on sick leave. Upper limb problems were most frequent. After adjustments, medium/high education predicted a lower risk of absence from work due to sickness and rapid RTW after 16 days. Back pain, fractures and female gender carried a higher risk of sickness certification but faster RTW. Older age was associated with less initial certification, more sick leave exceeding 16 days and slower RTW. Male patients with male GPs had a lower risk of sickness absence, which was similar to patients with GPs born in Norway and GPs with many patients. After 16 days, GP variables had no effect on RTW. CONCLUSION:Upper limb problems and GPs as stakeholders in 'the inclusive workplace' strategy need more attention.

Dataset Information

Psychiatrists' work with sickness certification: frequency, experiences and severity of the certification tasks in a national survey in Sweden.

Publications

Psychiatrists' work with sickness certification: frequency, experiences and severity of the certification tasks in a national survey in Sweden.

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