Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.
Med J Aust. 2013 Oct 7;199(7):480-3. doi: 10.5694/mja13.10508.
To examine patterns of the sickness certification of workers compensation claimants by general practitioners in Victoria, Australia, by nature of injury or illness.
DESIGN, SETTING AND PATIENTS: Retrospective analysis of Victorian workers compensation data for all injured and ill workers with an accepted workers compensation claim between 2003 and 2010.
Type (unfit for work, alternative duties, or fit for work) and duration of initial medical certificates relating to workers compensation claims that were issued by GPs, in six categories of injury and illness.
Of 124,424 initial medical certificates issued by GPs, 74.1% recommended that workers were unfit for work and 22.8% recommended alternative duties. Unfit-for-work certificates were issued to 94.1% of workers with mental health conditions, 81.3% of those with fractures, 79.1% of those with other traumatic injuries, 77.6% of those with back pain and strains, 68.0% of those with musculoskeletal conditions and 53.0% of those with other diseases. Alternative-duties certificates were significantly longer in duration than unfit-for-work certificates in all injury and illness categories (P < 0.001) but certificates for workers with musculoskeletal injuries and diseases, back pain and strains and other traumatic injuries were of lesser duration than those for workers with fractures, mental health conditions and other diseases.
The high proportion of medical certificates recommending complete absence from work presents major challenges in terms of return to work, labour force productivity, the viability of the compensation system, and long-term social and economic development. There is substantial variation in the type and duration of medical certificates issued by GPs. People with mental health conditions are unlikely to receive a certificate recommending alternative duties. Further research is required to understand GP certification behaviour.
通过维多利亚州（澳大利亚）全科医生开具的工人赔偿索赔者的病假证明，研究其受伤或患病的性质。
设计、设置和患者：对 2003 年至 2010 年间所有接受工人赔偿索赔的受伤和患病工人的维多利亚州工人赔偿数据进行回顾性分析。
在六个受伤和患病类别中，全科医生开具的与工人赔偿索赔相关的初始医疗证明的类型（不适合工作、替代工作或适合工作）和持续时间。
在全科医生开具的 124424 份初始医疗证明中，74.1%建议工人不适合工作，22.8%建议替代工作。心理健康状况的工人中 94.1%、骨折的工人中 81.3%、其他创伤性损伤的工人中 79.1%、背痛和劳损的工人中 77.6%、肌肉骨骼疾病的工人中 68.0%和其他疾病的工人中 53.0%收到不适合工作的证明。在所有受伤和患病类别中，替代工作的证明持续时间明显长于不适合工作的证明（P < 0.001），但肌肉骨骼损伤和疾病、背痛和劳损以及其他创伤性损伤的工人的证明持续时间短于骨折、心理健康状况和其他疾病的工人。
建议完全缺勤的病假证明比例很高，这给重返工作岗位、劳动力生产力、赔偿制度的可行性以及长期的社会和经济发展带来了重大挑战。全科医生开具的证明的类型和持续时间存在很大差异。心理健康状况的人不太可能收到建议替代工作的证明。需要进一步研究以了解全科医生的认证行为。
