Presentation M O16

M O16 (Oral Presentation):
Physicians across European countries agree on sick leave decisions

Presented by: Erik L. Werner

Authors

Werner EL1, Maeland S2, Canevet J-P3, Millet C3, Doussin L3, Eriksen H2

  1. Research Unit for General Practice, Uni Research, Bergen, Norway
  2. Uni Research Health, Bergen, Norway
  3. UFR Medecine Generale, University of Nantes, France

Abstract

Background

The sick leave rate in Norway is higher than in most other countries. It has been questioned whether this may be due to a too generous attitude among Norwegian physicians towards their patients. About 2/3 of all patients on sick leave have subjective health complaints (SHC) without corresponding objective findings. In this study we wanted to explore which diagnoses physicians put on patients with SHC and if they would grant sick leave or not. We compared the Norwegian results with physicians from three other countries to see if the assessments differed across the countries.

Methods

Patients with SHC were video recorded at their visit to their regular family doctor. Nine cases were reproduced with actors replacing the patient. Family doctors in Norway, Sweden, Denmark and France assessed all nine case stories. The physicians were asked to give up to three appropriate diagnoses for each patient and provide their assessment of the patients' work capacity. The diagnoses were given according to the International Classification of Primary Care (ICPC-2).

Results

Although every patient was given a substantial number of different diagnoses, up to 31, we found a great coherence between the assessments of the Scandinavian and French physicians. In 78% of the cases the physicians agreed on the ICPC chapter suggested for the primary diagnosis across all countries. In one of the nine cases there were differences between the French and the Scandinavian physicians regarding granting a sick note. All together the physicians agreed in 89% on their assessments of sick leave.

Conclusions

Patients with severe SHC present a great number of complaints and symptoms. All diagnoses proposed by the physicians are accurate according to the patients’ presentation of his / her health status. Although the physicians see differently on the patients in terms of medical diagnoses, there is a fairly high agreement on their assessment of the patients’ work capacity. Assessments of work capacity seem to be made on other determinants than the medical condition alone. Furthermore, we did not find differences across the countries. This suggests that French and Scandinavian family doctors view these patients’ work capacity similarly.

Schedule Details

Monday September 29
13:45 - 15:15 Afternoon Concurrent Sessions (M O13 - M O24 and Seminar 2)
Session: Healthcare providers’ interventions I
Room B