Rudbeck Marianne
Department of Social Medicine, Aalborg University Hospital, Denmark
Scand J Public Health. 2014 Nov;42(7):621-6. doi: 10.1177/1403494814541019. Epub 2014 Jun 27.
General practitioners (GPs) assess the existence of the patient's disease, decide whether the disease affects the patient's ability to work and if necessary, recommend sick leave. Our aim was to describe correlations in patients' sick leave between GP practices (GPPs) in a 5-year period.
The study included 253 GPPs, from 2007 to 2011. The personal numbers of patients from each GPP were connected to DREAM, a registry at the Danish Ministry of Employment that includes social welfare payments, including sick leave benefits. We adjusted for patient age, gender, ethnicity and social differences. Spearman's rank correlation coefficients (2007 - 2011) were used for calculating the correlation in adjusted sick leave.
The number of patient sick leave weeks between GPPs varied from 36 to 2,704 sick leave weeks per 1000 patients (18 - 65 years). The correlation coefficients for adjusted sick leave weeks varied from 0.90 to 0.94 (P < 0.05). Correlations for the 10 GPPs with the highest number of sick leave weeks and the 10 GPPs with the lowest number of sick leave weeks were almost as high as the correlations of the total population of GPPs.
The study showed great differences in sick leave between GPPS; however, significant correlation for adjusted sick leave in each GPP was demonstrated this may indicate that GPS play an important role in their patients' sick leave the study provides a method to distinguish between gpps with low patient sick leave and high patient sick leave in causal studies of sick leave differences among GPS.
全科医生(GPs)评估患者疾病的存在情况,决定该疾病是否影响患者的工作能力,如有必要,建议病假。我们的目的是描述五年期间全科医生诊所(GPPs)之间患者病假的相关性。
该研究纳入了2007年至2011年的253家GPPs。每个GPPs的患者个人编号与丹麦就业部的一个登记处DREAM相关联,该登记处包括社会福利支付,其中包括病假福利。我们对患者的年龄、性别、种族和社会差异进行了调整。使用Spearman等级相关系数(2007 - 2011年)来计算调整后病假的相关性。
每1000名患者(18 - 65岁)的GPPs之间患者病假周数从36周到2704周不等。调整后病假周数的相关系数从0.90到0.94不等(P < 0.05)。病假周数最多的10家GPPs和病假周数最少的10家GPPs之间的相关性几乎与GPPs总人口的相关性一样高。
该研究显示GPPs之间病假存在很大差异;然而,证明了每个GPPs调整后病假的显著相关性,这可能表明全科医生在其患者的病假中发挥着重要作用。该研究提供了一种在全科医生病假差异的因果研究中区分患者病假少和患者病假多的GPPs的方法。