Section for Social Medicine, Institute of General Practice and Community Health, Faculty of Medicine, University of Oslo, Norway.
Scand J Public Health. 2010 Mar;38(2):192-9. doi: 10.1177/1403494809357096. Epub 2010 Jan 7.
A method for structured functional assessments of persons with long-term sick leave was implemented in a cluster randomised controlled trial in general practice. The aim was to analyse intervention effects on general practitioner (GP) sick-listing practice and patient sick leave.
57 GPs were randomly assigned to an intervention or a control group. The intervention group GPs learned the method at a 1-day workshop including teamwork and role-playing. The control group GPs were requested to assess functional ability as usual during the 8 months intervention period in 2005. Outcome measures included duration of patient sick leave episodes, GP prescription of part-time sick leave, active sick leave, and vocational rehabilitation. This data was extracted from a national register.
The GPs in the intervention group prescribed part-time sick leave more often (p < 0.01) and active sick leave less often (p = 0.04) than the control group GPs during the intervention period. There was no intervention effect on duration of patient sick leave episodes or on GP prescription of vocational rehabilitation.
Implementing structured functional assessments in general practice made the GPs capable to assess functional ability of persons with long-term sick leave in a standardised and explicit manner. The intervention GPs' sick-listing practice was changed as they prescribed more part-time and less active sick leave compared to the control group GPs. As a result, more intervention GP patients returned to part-time work compared to control GP patients. No intervention effect was seen on duration of patient sick leave episodes or on prescription of vocational rehabilitation.
在一项基层医疗单位的群组随机对照试验中，实施了一种针对长期病假人员的结构化功能评估方法。目的是分析干预措施对全科医生（GP）病假登记实践和患者病假的影响。
57 名全科医生被随机分配到干预组或对照组。干预组的全科医生参加了为期 1 天的工作坊，包括团队合作和角色扮演，学习该方法。对照组的全科医生被要求在 2005 年的 8 个月干预期间按照常规评估患者的功能能力。结局指标包括患者病假发作的持续时间、GP 开具部分病假、积极病假和职业康复的情况。这些数据是从国家登记处提取的。
干预组的 GP 比对照组 GP 更频繁地开具部分病假（p < 0.01）和较少地开具积极病假（p = 0.04），在干预期间。干预对患者病假发作的持续时间或 GP 开具职业康复的情况没有影响。
在基层医疗实践中实施结构化功能评估，使 GP 能够以标准化和明确的方式评估长期病假人员的功能能力。干预组的 GP 在病假登记实践方面发生了变化，他们开具了更多的部分病假和较少的积极病假，与对照组 GP 相比。因此，与对照组 GP 患者相比，更多的干预组 GP 患者恢复了部分工作。干预对患者病假发作的持续时间或职业康复的处方没有影响。
