Physician’s work with sickness certification of patients; results from 4 very large Swedish surveys

Alexanderson, Kristina; Haque, Mohammad Israrul; Svärd, Veronica; Friberg, Emilie; Arrelöv, Britt; Nilsson, Gunnar

doi:10.1093/eurpub/cky212.179

Cited by 3 publications

(3 citation statements)

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“…A questionnaire was developed to collect information from RTW coordinators about their work with patient rehabilitation and the RTW process, patient selection, work tasks, work situation, collaboration with stakeholders, educational background, and sociodemographic characteristics. The questionnaire, which contained 41 questions plus partial questions, was developed from previous questionnaires about the work of physicians [27,28] and coordinators [29] with patients on SA. It was also discussed in a reference group comprising coordinators, physicians and other stakeholders in the RTW process.…”

Section: The Coordinator Datasetmentioning

confidence: 99%

Coordinators in the return-to-work process: Mapping their work models

et al. 2023

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Purpose In recent decades, many countries have implemented return-to-work coordinators to combat high rates of sickness absence and insufficient collaboration in the return-to-work process. The coordinators should improve communication and collaboration between stakeholders in the return-to-work process for people on sickness absence. How they perform their daily work remains unexplored, and we know little about to what extent they collaborate and perform other work tasks to support people on sickness absence. This study examines which work models return-to-work coordinators use in primary healthcare, psychiatry and orthopaedics in Sweden. Methods A questionnaire was sent to all 82 coordinators in one region (89% response rate) with questions about the selection of patients, individual patient support, healthcare collaboration, and external collaboration. Random forest classification analysis was used to identify the models. Results Three work models were identified. In model A, coordinators were more likely to select certain groups of patients, spend more time in telephone than in face-to-face meetings, and collaborate fairly much. In Model B there was less patient selection and much collaboration and face-to-face meetings. Model C involved little patient selection, much telephone contact and very little collaboration. Model A was more common in primary healthcare, model C in orthopaedics, while model B was distributed equally between primary healthcare and psychiatry. Conclusion The work models correspond differently to the coordinator’s assignments of supporting patients and collaborating with healthcare and other stakeholders. The differences lie in how much they actively select patients, how much they collaborate, and with whom. Their different distribution across clinical contexts indicates that organisational demands influence how work models evolve in practice.

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Section: The Coordinator Datasetmentioning

confidence: 99%

Coordinators in the return-to-work process: Mapping their work models

et al. 2023

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“…A cross-sectional study was conducted, based on data from a comprehensive questionnaire sent to all physicians in clinics handling SC of patients, ⩽68 years of age, who worked and lived in Sweden in 2017 (n = 34,585). The questionnaire contained 133 questions regarding physicians' SC practices [23] and was administered by Statistics Sweden. It was sent to the physicians' home addresses, with up to four reminders to non-responders.…”

Section: Study Population and Designmentioning

confidence: 99%

Factors associated with general practitioners’ contacts with sick-listed patients’ employers: A Swedish nationwide questionnaire study

Nordling

Alexanderson

Hensing

et al. 2021

Scand J Public Health

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Background: General practitioners’ (GP) contacts with sick-listed patients’ employers have been shown to be of importance for return to work. This study aimed to explore GPs’ contacts with sick-listed patients’ employers and factors associated with such contacts. Methods: In this cross-sectional study, 4228 GPs responded to a nationwide questionnaire about sickness certification (SC) practices. Outcomes of interest were participation in stakeholder meetings, having other contacts with employers, and satisfaction with employer contacts. Logistic regression models were used to investigate associations with factors related to the GP and the GP’s workplace. Results: Among GPs, 34.8% participated in stakeholder meetings and 15.1% had other employer contacts; 39.4% had any or both of these contacts. Of GPs who had contacts with patients’ employers, 65.8% were satisfied with the contacts. GPs regularly collaborating with rehabilitation coordinators had the strongest adjusted odds ratio (OR) for participating in stakeholder meetings, OR 2.72 (95% confidence interval (CI) 2.24–3.31), and having other contacts with employers, OR 3.85 (95% CI 2.85–5.21). Other factors positively associated with employer contacts were being a specialist, collaborating with other health professionals, finding employer contacts valuable, and having a joint SC routine/policy at the clinic. GPs who did not find SC problematic, had managerial support, or had enough resources for SC tasks were more likely to be satisfied with their employer contacts. Conclusions: Both physician characteristics and organizational factors had importance for GPs’ contacts with sick-listed patients’ employers. The findings imply that GPs’ collaboration with patients’ employers may be improved by interventions targeting both individual and organizational factors.

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“…The most recent evidence on physicians' experiences with sickness certification indicates that the changes were not sufficient to resolve the underlying problems. In a comparison of similar surveys carried out at four different points in time, with the latest in 2017, Alexanderson et al (2018) came to the conclusion that the share of physicians experiencing sickness certification as problematic has not decreased, and that GPs “experienced problems in sickness certification to the largest extent.” The task experienced as most problematic was the assessment of duration and level of the patient's work incapacity. With respect to the certification guidelines, slightly less than a third reported that they improved the quality of how they handle sickness certification tasks and about half experienced that the guidelines facilitate their contact with patients (Svärd & Alexanderson, 2019).…”

Section: The Assessment Of Work Abilitymentioning

confidence: 99%

Sick but at work: Graded sick leave in a comparative perspective

Leoni

2020

Soc Policy Adm

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Measures to activate sick-listed workers and to combine work with sickness benefits are a growing but little-studied policy field. This article investigates graded sick leave benefits in Sweden, Finland and Germany. The analysis reveals some commonalities between countries, as well as substantial differences in terms of institutional background, benefit design and governance. The schemes range from models in which grading has become an integral component of the regular sickness certification process, to models in which the graded-work option is targeted at a much smaller category of workers and has a stronger therapeutic character. The variation in design and governance of the models is reflected in large differences in terms of their diffusion. All schemes face a common set of obstacles and challenges. They relate in particular to the distribution of stakeholders' roles and responsibilities, the involvement of employers and the assessment of residual work ability.

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Physician’s work with sickness certification of patients; results from 4 very large Swedish surveys

Cited by 3 publications

References 0 publications

Coordinators in the return-to-work process: Mapping their work models

Coordinators in the return-to-work process: Mapping their work models

Factors associated with general practitioners’ contacts with sick-listed patients’ employers: A Swedish nationwide questionnaire study

Sick but at work: Graded sick leave in a comparative perspective

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