Quality of sickness certification in primary health care: a retrospective database study

BMC Family Practice

Research Article

Gunnar H Nilsson¹  Magdalena Fresk¹  Ylva Skånér¹  Lars G Backlund¹  Britt Arrelöv²  Amanda Waleh Åström³ 

[1] Department of Neurobiology, Care Sciences and Society, Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden;Department of Neurobiology, Care Sciences and Society, Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden;Stockholm County Council, Stockholm, Sweden;Stockholm County Council, Stockholm, Sweden;

关键词: General practitioners;    Sick leave;    Sickness certificates;    Quality indicators;    Health care;   

DOI  :  10.1186/1471-2296-14-48

 received in 2012-12-21, accepted in 2013-04-08,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundIn the period 2004–2009, national and regional initiatives were developed in Sweden to improve the quality of sickness certificates. Parameters for assessing the quality of sickness certificates in primary health care have been proposed. The aim of this study was to measure the quality of sickness certification in primary health care by means of assessing sickness certificates issued between 2004 and 2009 in Stockholm.MethodsThis was a retrospective study using data retrieved from sickness certificates contained in the electronic patient records of 21 primary health care centres in Stockholm County covering six consecutive years. A total number of 236 441 certificates were used in the current study. Seven quality parameters were chosen as outcome measures. Descriptive statistics and regression models with time, sex and age group as explanatory variables were used.ResultsDuring the study period, the quality of the sickness certification practice improved as the number of days on first certification decreased and the proportion of duly completely and acceptable certificates increased. Assessment of need for vocational rehabilitation and giving a prognosis for return to work were not significantly improved during the same period. Time was the most influential variable.ConclusionsThe quality of sickness certification practice improved for most of the parameters, although additional efforts to improve the quality of sickness certificates are needed. Measures, such as reminders, compulsory certificate fields and structured guidance, could be useful tools to achieve this objective.

【 授权许可】

CC BY   
© Skånér et al.; licensee BioMed Central Ltd. 2013