Sturesson Marine, Bylund Sonya Hörnqvist, Edlund Curt, Falkdal Annie Hansen, Bernspång Birgitta
Department of Community Medicine and Rehabilitation, Division of Occupational Therapy, Umeå University Sweden
County Council of Västerbotten, Sweden.
Scand J Public Health. 2015 Dec;43(8):841-7. doi: 10.1177/1403494815597163. Epub 2015 Jul 30.
In Sweden, the information in the sickness certificate is crucially important for the sick-listed person as well as for the Swedish Social Insurance Agency and the sick-listed person's employer. The certificate is used as the basis for deciding whether a person is entitled to sickness benefits. Further, it communicates information significant for the return-to-work process. The aim of the study was to evaluate the quality of sickness certificates issued in primary health care and examine if the patients' or physicians' gender influences the information in the sickness certificate.
An insurance specialist at the Swedish Social Insurance Agency assessed the quality of the stated information in a sample of 323 certificates issued by 146 different general practitioners at 29 different primary health care centres in northern Sweden.
Thirty-four percent of the certificates did not contain sufficient information requested. The areas of the certificates in need of supplementary information were mainly the descriptions of impairment of body function and activity limitation. More certificates issued for women than certificates issued for men lacked the required information. Full-time sick leave was more often prescribed for male patients than for female. Significant differences between certificates issued for women and certificates issued for men appeared in the group of musculoskeletal diseases. No differences in quality aspects connected to physicians' gender were found.
Our study indicates a need for increased knowledge about the descriptions of functioning for sick-listed persons; more cooperation between health professionals in primary health care and a better gender awareness in health care encounters.
在瑞典，疾病证明书中的信息对病假人员、瑞典社会保险机构以及病假人员的雇主都至关重要。该证明用作判定一个人是否有权享受病假福利的依据。此外，它还传达对重返工作岗位过程有重要意义的信息。本研究的目的是评估初级卫生保健中开具的疾病证明书的质量，并检查患者或医生的性别是否会影响疾病证明书中的信息。
瑞典社会保险机构的一名保险专家对瑞典北部29个不同初级卫生保健中心的146名不同全科医生开具的323份证明书样本中所陈述信息的质量进行了评估。
34%的证明书没有包含所要求的足够信息。需要补充信息的证明书领域主要是身体功能损害和活动受限的描述。女性的疾病证明书比男性的疾病证明书缺少所需信息的情况更多。男性患者比女性患者更常被开具全时病假。在肌肉骨骼疾病组中，女性的疾病证明书和男性的疾病证明书之间存在显著差异。未发现与医生性别相关的质量方面的差异。
我们的研究表明，需要增加对病假人员功能描述的了解；初级卫生保健中的卫生专业人员之间需要更多合作，并且在医疗保健接触中需要提高性别意识。
