Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Scand J Public Health. 2010 Aug;38(6):657-63. doi: 10.1177/1403494810373674. Epub 2010 Jun 9.
The aim was to study whether sick-leave diagnoses of long-term sickness absentees were modified after a multidisciplinary assessment and if modifications differed with type of medical specialty of the latest physician to sick-list the patient.
A sample of 635 long-term sickness absentees referred to a multidisciplinary assessment by Social Insurance Offices was included. Data were obtained through sickness certificates and medical records. Patients were examined by board-certified specialists in psychiatry, orthopaedic surgery, and rehabilitation medicine. Descriptive statistics were used.
The multidisciplinary assessment resulted in an increase from 1-2 to 2-3 diagnoses for most patients. Forty-five per cent of the male and 47% of the female patients had only somatic diagnoses at referral. After the multidisciplinary assessment these percentages were 20% and 29%, respectively. The rate of women and men given both psychiatric and somatic diagnoses increased from 30% at referral to about 55%. The shift from either only psychiatric or only somatic diagnoses to having these diagnoses in combination was associated with type of specialty of the physician who had sick-listed the patient.
The study indicates that many patients on long-term sick-leave with unclear diagnoses may suffer from unrecognized, and therefore probably untreated, medical disorders and co-morbidity.
研究多学科评估后长期请病假者的病假诊断是否会发生改变，以及最新为患者开病假条的医生的医疗专科类型是否会影响这种改变。
本研究纳入了社会保险局转介的 635 名长期请病假者的样本。数据通过病假证明和病历获得。患者由精神病学、矫形外科和康复医学领域的认证专家进行检查。采用描述性统计方法。
多学科评估后，大多数患者的诊断从 1-2 种增加到 2-3 种。45%的男性和 47%的女性患者在转介时只有躯体诊断。在多学科评估后，这两个比例分别为 20%和 29%。接受精神科和躯体诊断的女性和男性的比例从转介时的 30%增加到约 55%。从仅接受精神科或仅接受躯体诊断转变为同时接受这些诊断与为患者开病假条的医生的专业类型有关。
本研究表明，许多长期请病假且诊断不清的患者可能患有未被识别的、可能未经治疗的医疗障碍和合并症。
