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[通过增加全科医生的知识能否减少病假?]

[Could sick leaves be reduced by augmenting the knowledge of the general practitioner?].

作者信息

Lie Håkon

机构信息

Arnegårdsveien 7A, og, Ringerike sykehus, 3500 Hønefoss.

出版信息

Tidsskr Nor Laegeforen. 2003 Aug 14;123(15):2068-71.

Abstract

BACKGROUND

Musculoskeletal disorders account for about 50 % of the cost of sick leaves in Norway. The aim of the study was to evaluate whether it is possible cut down the length of such sick leaves by augmenting the knowledge of these disorders among general practitioners (GPs).

MATERIAL AND METHODS

Among GPs in a region of 50 000 inhabitants in Buskerud county, 24 joined a continuous medical education programme on musculoskeletal disorders and received financial compensation for the extra time spent on an extended clinical examination of patients whose sick leave had exceeded 16 days. 41 GPs that did not wish to attend the programme joined the study as a control group. Patients were included over one year and there was a one-year follow-up period.

RESULTS

The GPs in the programme had a total of 753 patients who were included in the study; the GPs in the control group had 964. There were no differences between these patient groups with regard to sex, age, occupation and diagnosis, in length of sick leaves, or more permanent disability benefits. Among patients on sick leave of more than one year, 55% had not been referred to a specialist.

INTERPRETATION

Augmenting the skills of GPs and giving them incentives to conduct more thorough clinical examinations does not reduce length of sick leaves caused by musculoskeletal disorders.

摘要

背景

在挪威,肌肉骨骼疾病约占病假成本的50%。本研究的目的是评估通过增加全科医生(GP)对这些疾病的了解,是否有可能缩短此类病假的时长。

材料与方法

在布斯克吕德郡一个有5万居民的地区的全科医生中,24人参加了关于肌肉骨骼疾病的继续医学教育项目,并因额外花费时间对病假超过16天的患者进行扩展临床检查而获得经济补偿。41名不想参加该项目的全科医生作为对照组加入研究。患者纳入时间超过一年,并进行了为期一年的随访。

结果

参加项目的全科医生共有753名患者被纳入研究;对照组的全科医生有964名。这些患者组在性别、年龄、职业、诊断、病假时长或更长期的残疾福利方面没有差异。在病假超过一年的患者中,55%未被转诊至专科医生处。

解读

提高全科医生的技能并激励他们进行更全面的临床检查,并不会缩短由肌肉骨骼疾病导致的病假时长。

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