Disability assessments: Effects of response mode and experience

Kerstholt, Johanna Helena; Boer, W.E.L. de; Jansen, Niels

doi:10.1080/09638280500163794

Cited by 24 publications

(19 citation statements)

References 13 publications

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“…A higher proportion responded this in 2012 than in 2008. Our results are in line with studies of physicians from other specialties, showing that assessing the patient's work capacity is problematic in sickness certifications [21, 24]. This is an important area to highlight in further interventions aiming at improving competence and provide organizational support.…”

Section: Discussionsupporting

confidence: 89%

Obstetricians/Gynecologists’ Problems in Sickness Certification Consultations: Two Nationwide Surveys

Gustavsson

Hinas

Ljungquist

et al. 2016

Obstetrics and Gynecology International

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Objective. To explore experiences by physicians working in obstetrics, gynecology, or maternal healthcare (O/Gs) of problems in sickness certification consultations and differences between two years. Material and Methods. Answers by O/Gs to two Swedish nationwide surveys, in 2008 (n = 1037) and 2012 (n = 992), were analyzed for frequencies and severity of problems and organizational support in sickness certification consultations. Results. One-third of O/Gs found sickness certifications problematic every week. The most frequent problem was patients requesting sick notes for reasons other than work incapacity due to disease/injury (2008: 21%; 2012: 16%). The most problematic were assessing work capacity (2008 and 2012: 52%) and having different opinion from that of the patient about need for sick leave (2008: 51%; 2012: 46%). In 2012, 27% used the national sickness certification guidelines weekly, compared to 9% in 2008. A larger proportion in 2012 than 2008 reported that the guidelines facilitated contacts with patients and different stakeholders. Conclusions. Although O/Gs perceived sickness certification as problematic, there was less perceived severity of problems in 2012 compared to 2008, possibly because interventions regarding sickness certification have been introduced in Sweden recent years. Still, more organizational support, for example, time and supervision, are needed to enhance O/Gs' sickness certification practices.

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Section: Discussionsupporting

confidence: 89%

Obstetricians/Gynecologists’ Problems in Sickness Certification Consultations: Two Nationwide Surveys

Gustavsson

Hinas

Ljungquist

et al. 2016

Obstetrics and Gynecology International

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“…Critics across Europe have pointed to the lack of reliability and transparency in disability evaluation [1][2][3][4][5][6], with the heterogeneous presentation of findings in the medical reports being one of the reasons. When confronted with similar challenges a decade ago, the international rehabilitation community has started to picture the situation of people with disability by using the International Classification of Functioning, Disability and Health (ICF) [7].…”

Section: Introductionmentioning

confidence: 99%

“…These components are further subdivided in 1424 categories [8]. The ICF provides a common point of reference for conceptualizing disability [2] which may facilitate standardized reporting about work disability across countries [4,9].…”

Section: Introductionmentioning

confidence: 99%

Reporting about disability evaluation in European countries

Anner

Kunz

Boer

2013

Disability and Rehabilitation

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Official requirements on medical reporting about disability in social insurance across Europe follow the frame of four features: work capacity, socio-medical history, feasibility of intervention and prognosis of disability. There is an increasing trend to make formal or informal reference to the ICF in the reports about working capacity. The four features and the ICF may provide common references across countries to describe disability evaluation, facilitating national and international research. Implications for Rehabilitation Reporting about disability in social insurance in different countries is about work capacity, social medical history, feasibility of intervention and prognosis of disability. Formats of reporting on work capacity vary among countries, from free text to semi-structured report forms to fully structured and scaled report forms of working capacity. The ICF could serve as a reference for describing work capacity, provided the ICF contains all necessary categories.

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“…Problems reported were related to handling disagreements with patients about the need of a sickness certification; decisions of whether to certify a prolongation of a sick-leave period that was initiated by another physician; assessments of a patient’s work ability; and determination of optimal duration and degree of certification [11-13]. Several other studies in different countries have reported similar findings [14-20]. …”

Section: Introductionmentioning

confidence: 99%

Sickness certification as a complex professional and collaborative activity - a qualitative study

Kiessling

Arrelöv

2012

BMC Public Health

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BackgroundPhysicians have an important but problematic task to issue sickness certifications. A manifold of studies have identified a wide spectrum of medical and insurance-related problems in sickness certification. Despite educational efforts aiming to improve physicians’ knowledge of social insurance medicine there are no signs of reduction of these problems. We hypothesised that the quality deficits is not only due to lack of knowledge among issuing physicians. The aim of the study was to explore physicians’ challenges when handling sickness certification in relation to their professional roles as physicians and to their interaction with different stakeholders.MethodsOne hundred seventy-seven physicians in Stockholm County, Sweden, participated in a sick-listing audit program. Participants identified challenges in handling sick-leave issues and formulated action plans for improvement. Challenges and responsible stakeholders were identified in the action plans. To deepen the understanding facilitators of the program were interviewed. A qualitative content analysis was performed exploring challenge categories and categories of stakeholders with responsibility to initiate actions to improve the quality of the sick-listing process. The challenge categories were then related by their content to professional competence roles in accord with the Canadian Medical Education Directions for Specialists (CanMEDS) framework and to the stakeholder categories.ResultsSeven categories of challenges were identified. Practitioner patient interaction, Work capacity assessment, Interaction with the Social Insurance Administration, The patient’s workplace and the labour market, Sick-listing practice, Collaboration and resource allocation within the Health Care System, Leadership and routines at the Health Care Unit. The challenges were related to all seven CanMEDS roles. Five categories of stakeholders were identified and several stakeholders were involved in each challenge category.ConclusionsPhysicians performing sickness certification tasks experience a complex variety of challenges. From physician perspective actions to handle these need to be initiated in interaction with both medical and non-medical stakeholders. The relation between the challenges and a well-established professional competence framework revealed a complex pattern. Thus, from a public health perspective, educational activities aimed to improve the sick-listing process should address all physician competences including identification and interaction with stakeholders, and not just knowledge of social insurance medicine.

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Disability assessments: Effects of response mode and experience

Cited by 24 publications

References 13 publications

Obstetricians/Gynecologists’ Problems in Sickness Certification Consultations: Two Nationwide Surveys

Obstetricians/Gynecologists’ Problems in Sickness Certification Consultations: Two Nationwide Surveys

Reporting about disability evaluation in European countries

Sickness certification as a complex professional and collaborative activity - a qualitative study

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