A'Rashdy Faiz, Al-Hosni Khamis, Al-Rawahi Abdulhakeem, Theodorsson Thord
General Medicine, Bediyah Hospital, Bediyah, Oman.
General Medicine, Army Forces Health Services, Muscat, Oman.
Oman Med J. 2015 Mar;30(2):95-9. doi: 10.5001/omj.2015.21.
Sickness certification (SC) is common practice in primary health care with proven implications on the health system. To assess the rate of sickness certifications in the Bowsher province and describe related demographic, occupational and medical factors.
Our retrospective, cross-sectional study retrieved data for all consultations, with patients aged six to 65 years old, which ended with SC. The data from four primary health care centers in the Bowsher provice were collected during 2011 using the electronic medical record system. Collected data included patient demographics, occupation, date issued, duration of sickness certification, recorded vital signs, and clinical diagnosis. Suitable rates were calculated as percentages and important differences were compared using the chi-square test.
The total number of consultation visits for the targeted population was 189,275. Of these 26,096 consultations resulted in SC to a total of 15,758 patients. The overall rate of SC was 13.8 per 100 consultation-years (confidence interval (CI): 13.6-14). SC rates in males were significantly higher than females (17 and 11 per 100 consultations/year, respectively). Patients aged 19-29 years old had the highest rate of SC (18.6/100 consultations/year). School students aged six to 18 years made up 28% of patients, and 24% and 22% of patients were working in the private and public sectors, respectively. No vital signs record was found for 30% of SC visits. The highest rate of SC was in October (17%) and the lowest was in August (9%). Acute respiratory infections were the most frequent diagnoses (31%) resulting in certifications. The rate of SC issued for Omanis and non-Omanis was 14 and 9 per 100 consultations per year, respectively.
Sickness certification is a burden on primary health care in the studied health centers with approximately one in seven consultations ending with SC issued. More investigations are needed to identify determinates of high sickness absence. Robust guidelines are important to regulate the number of sickness certificates issued.
疾病证明（SC）在初级卫生保健中是常见做法，已证实对卫生系统有影响。评估鲍舍尔省的疾病证明率，并描述相关的人口统计学、职业和医学因素。
我们的回顾性横断面研究检索了所有以SC结束的、年龄在6至65岁患者的会诊数据。2011年期间，使用电子病历系统收集了鲍舍尔省四个初级卫生保健中心的数据。收集的数据包括患者人口统计学信息、职业、发证日期、疾病证明持续时间、记录的生命体征和临床诊断。合适的比率以百分比计算，并使用卡方检验比较重要差异。
目标人群的会诊总数为189,275次。其中，26,096次会诊导致向总共15,758名患者发放了SC。SC的总体发生率为每100会诊年13.8次（置信区间（CI）：13.6 - 14）。男性的SC发生率显著高于女性（分别为每100次会诊/年17次和11次）。19至
