Winde Lee, Haukenes Inger, Hetlevik Øystein, Gjesdal Sturla
Forskningsgruppe for sosial epidemiologi, Institutt for samfunnsmedisinske fag, Universitetet i Bergen, Norway.
Tidsskr Nor Laegeforen. 2013 Jan 8;133(1):28-32. doi: 10.4045/tidsskr.11.1340.
Undertaking research on the role of regular GPs with regard to rates of sickness absence is methodologically challenging, and existing results show a wide divergence. We investigated how long-term sickness absence is affected by the characteristics of doctors and their patient lists.
The study encompassed all those vocationally active residents of Oslo and Bergen in 2005-2006 who had the same regular GP throughout 2006 (N = 298,039). Encrypted data on sickness absence for each individual in 2006, as well their age, gender and level of education were merged with data on the regular GPs (N = 568) and their patient lists, and subsequently analysed with the aid of logistic regression. The outcome variable was at least one period of sickness absence which had been paid for by the Norwegian Labour and Welfare Administration (NLWA). The explanatory variables included the age, gender, list length and list status (open/closed) of the regular GPs, as well as variables that characterised the composition of the patient lists. The analyses were stratified by gender and controlled for individual age and education.
The age, gender and list length of the regular GPs were not associated with sickness absence paid for by the NLWA. The odds ratio for sickness absence > 16 days was reduced for both women and men when the list contained many highly educated patients, a high proportion of elderly people and few disability pensioners. Men on lists with a high proportion of men and lists with a high proportion of vocationally active patients also had lower odds rates for sickness absence > 16 days. Among women, the rate of sickness absence was lower for those on open lists than for those on closed lists.
In addition to well-known individual factors, the study shows that the likelihood of sickness absence is affected by the socio-demographic composition of the patient list to which one belongs.
研究普通全科医生在病假率方面的作用在方法上具有挑战性，现有结果差异很大。我们调查了长期病假如何受到医生及其患者名单特征的影响。
该研究涵盖了2005 - 2006年奥斯陆和卑尔根所有职业活跃居民，这些居民在2006年全年都有同一位固定的全科医生（N = 298,039）。2006年每个个体的病假加密数据，以及他们的年龄、性别和教育程度，与固定全科医生（N = 568）及其患者名单的数据合并，随后借助逻辑回归进行分析。结果变量是至少有一段由挪威劳动和福利管理局（NLWA）支付费用的病假。解释变量包括固定全科医生的年龄、性别、名单长度和名单状态（开放/封闭），以及表征患者名单构成的变量。分析按性别分层，并控制个体年龄和教育程度。
固定全科医生的年龄、性别和名单长度与NLWA支付费用的病假无关。当名单上有许多高学历患者、高比例老年人且残疾养老金领取者很少时，男性和女性病假超过16天的比值比都会降低。男性比例高的名单以及职业活跃患者比例高的名单上的男性，病假超过16天的几率也较低。在女性中，开放名单上的女性病假率低于封闭名单上的女性。
除了众所周知的个体因素外，该研究表明病假的可能性还受到个人所属患者名单的社会人口构成的影响。
