Prescribing of Sick Leave by Surgeons: A Survey Based on Hypothetical Patient Cases

Kankaanpää, Anni T; Laato, Matti; Tuominen, Risto

doi:10.1007/s00268-013-2097-3

Cited by 4 publications

(4 citation statements)

References 25 publications

(44 reference statements)

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“…Surgeons have very different views of the optimal number of sick leave days for the same patient cases. [23] From a societal perspective this variability can markedly affect the potential cost savings as productivity losses are a key cost component. In this study at 5-year follow-up the antibiotic group patients were prescribed significantly less sick leave compared to patients in the operative group.…”

Section: Discussionmentioning

confidence: 99%

Cost analysis of antibiotic therapy versus appendectomy for treatment of uncomplicated acute appendicitis: 5-year results of the APPAC randomized clinical trial

et al. 2019

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Background The efficacy and safety of antibiotic treatment for uncomplicated acute appendicitis has been established at long-term follow-up with the majority of recurrences shown to occur within the first year. Overall costs of antibiotics are significantly lower compared with appendectomy at short-term follow-up, but long-term durability of these cost savings is unclear. The study objective was to compare the long-term overall costs of antibiotic therapy versus appendectomy in the treatment of uncomplicated acute appendicitis in the APPAC (APPendicitis ACuta) trial at 5 years. Methods and findings This multicentre, non-inferiority randomized clinical trial randomly assigned 530 adult patients with CT-confirmed uncomplicated acute appendicitis to appendectomy or antibiotic treatment at six Finnish hospitals. All major costs during the 5-year follow-up were recorded, whether generated by the initial visit and subsequent treatment or possible recurrent appendicitis. Between November 2009 and June 2012, 273 patients were randomized to appendectomy and 257 to antibiotics. The overall costs of appendectomy were 1.4 times higher (p<0.001) (€5716; 95% CI: €5510 to €5925) compared with antibiotic therapy (€4171; 95% CI: €3879 to €4463) resulting in cost savings of €1545 per patient (95% CI: €1193 to €1899; p<0.001) in the antibiotic group. At 5 years, the majority (61%, n = 156) of antibiotic group patients did not undergo appendectomy. Conclusions At 5-year follow-up antibiotic treatment resulted in significantly lower overall costs compared with appendectomy. As the majority of appendicitis recurrences occur within the first year after the initial antibiotic treatment, these results suggest that treating uncomplicated acute appendicitis with antibiotics instead of appendectomy results in lower overall costs even at longer-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Cost analysis of antibiotic therapy versus appendectomy for treatment of uncomplicated acute appendicitis: 5-year results of the APPAC randomized clinical trial

et al. 2019

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“…This highlights the importance of the human factor in the heterogeneity of sick leave prescribing, indicating the absence of standardized, evidence-based clinical practice guidelines. Other data showed that, for patients with the same diagnosis, surgeons prescribed more sick leave for those having physical jobs than for those working in an office [ 49 ]. Although the latter approach appears to be applicable in the context of rheumatology, it requires an evidence-based implementation to consider the other factors.…”

Section: Discussionmentioning

confidence: 99%

Sick Leave Patterns in Common Rheumatological Diseases

Jali¹

2023

Cureus

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The study aims to analyze the patterns and determinants of sick leaves (SL) associated with the most common rheumatological diseases and estimate the associated productivity loss cost (PLC). MethodA retrospective study reviewed all SLs that were issued from a rheumatology outpatient clinic between 2016 and 2019 for the following diagnoses: low back pain (LBP), knee osteoarthritis (OA), rheumatoid arthritis (RA), and disc disorders. The duration of each sick leave was captured and analyzed by patients' age category, gender, and diagnosis. The human capital method was used to estimate the PLC. ResultOne thousand and two SLs have been issued during the study period, for a cumulative 4,649 days. The majority of the patients were female (86.3%), and the mean (SD) age was 42.01 (10.71) years. SL durations ranged from 2 to 14 days. The most frequent diagnosis was RA (34.3%), followed by LBP (30.1%). Disc disorder, knee OA, and RA were independently associated with 2.01 (p=0.014), 9.07 (p<0.001), and 7.75 (p<0.001) odd ratios for long SL (≥7 days), by reference to LBP. The average PLC was estimated at $235.29 per day of sick leave, for a total cumulative cost of $235,755.30. ConclusionRheumatological diseases are responsible for approximately 4.5 days of SL prescribing per day in our clinic, with an average yearly cost of $58,938.83. Monitoring the pattern of sick leave and identifying the interplay between their cofactors are essential to developing a comprehensive approach to enable evidence-based clinical practices along with advancements in work-based protective measures and policies.

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“…The possibility of part-time work should also be considered. There is large variation in the duration of sick leave among patients with the same diagnosis, and the practices of prescribing sick leave have been shown to vary among physicians ( Kankaanpää et al., 2013 ). With the implementation of national guidelines and improved education of physicians, we might be able to reduce the number of sick leave days.…”

Section: Discussionmentioning

confidence: 99%

Duration of sick leave after operated and non-operated distal radial fracture: a Finnish cohort study of 19,995 patients

Ax,

Palola,

Ponkilainen

et al. 2023

J Hand Surg Eur Vol

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The purpose of this study was to investigate whether operative treatment for distal radial fracture reduces the length of sick leave and the costs of treatment. We identified 19,995 patients from a registry who received a state sick leave allowance between 2010 and 2019 owing to distal radial fractures. We compared these patients to a registry of operations and identified 4346 operated patients. Operated patients had a mean sick leave of 75 days, whereas non-operated patients had a sick leave of 63 days. In the operated group, the cost of sick leave was €7505 (UK£6419; US$8070), which was 34% higher than in the non-operated group. Over the analysed period, the duration of sick leave decreased. Although several studies have shown better early functional outcomes after operation, this does not seem to shorten sick leave. Level of evidence: III

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Prescribing of Sick Leave by Surgeons: A Survey Based on Hypothetical Patient Cases

Abstract: Structured education for surgeons on prescribing sick leave, together with defined guidelines, could produce more uniform practices and improve equality among patients.

Cited by 4 publications

References 25 publications

Cost analysis of antibiotic therapy versus appendectomy for treatment of uncomplicated acute appendicitis: 5-year results of the APPAC randomized clinical trial

Cost analysis of antibiotic therapy versus appendectomy for treatment of uncomplicated acute appendicitis: 5-year results of the APPAC randomized clinical trial

Sick Leave Patterns in Common Rheumatological Diseases

Duration of sick leave after operated and non-operated distal radial fracture: a Finnish cohort study of 19,995 patients

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