普通医学中的病假条开具：ECOGEN研究结果

Sick leave prescriptions in general medicine: results from the ECOGEN study.

作者信息

Bègue Cyril, Peurois Matthieu, Orvain Charlotte, Roquelaure Yves, Petit Audrey, Ramond-Roquin Aline

机构信息

Département de médecine générale, Univ Angers, Angers, F-49000, France.

Univ Angers, POPS, SFR ICAT, Angers, F-49000, France.

出版信息

BMC Prim Care. 2025 Apr 14;26(1):108. doi: 10.1186/s12875-025-02712-5.

DOI:10.1186/s12875-025-02712-5

PMID:40229692

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11995497/

Abstract

BACKGROUND

Sick leave is a significant social and economic concern, with substantial costs and potential adverse consequences for patients. Understanding the factors influencing sick leave prescriptions is essential to improve their relevance and impact. The principal objective of this study was to describe general medicine consultations that led to sick leave prescriptions.

METHODS

The ECOGEN study, conducted from November 2011 to April 2012 in France, systematically analysed thousands of general medicine consultations. Data collected from 10,271 consultations, involving non-retired patients aged 18 to 65, provided insights into the determinants of sick leave prescriptions. Various patient and General Practitioners (GP) characteristics, consultation details, and health issues were considered.

RESULTS

16.5% of the consultations analysed, resulted in sick leave prescriptions. Several determinants were identified. Older patients received fewer sick leave prescriptions. Laborers had higher prescription rates, reflecting their poorer health and harsh working conditions. Longer consultations were associated with lower prescription rates. Sick leave prescriptions varied by health issue, with higher rates for musculoskeletal, digestive, respiratory, social, and psychiatric problems.

CONCLUSION

Understanding the determinants of sick leave prescriptions is essential for their appropriate use. This study reveals the intricate interplay of patient characteristics, health issues, and GP factors in these decisions. Despite the fact that the study was not specifically designed to study the prescription of sick leave and that the data relate to a relatively short period, the winter of 2011-2012, it provides important insights into the prescription of sick leave. Improved comprehension can enhance the relevance and effectiveness of sick leave prescriptions, benefiting both individuals and society. Further qualitative research is necessary to explore the underlying factors driving these decisions in greater detail.

TRIAL REGISTRATION

Not applicable.

摘要

背景

病假是一个重大的社会和经济问题，对患者来说成本高昂且可能产生不良后果。了解影响病假开具的因素对于提高其相关性和影响至关重要。本研究的主要目的是描述导致病假开具的普通内科会诊情况。

方法

2011年11月至2012年4月在法国进行的ECOGEN研究系统分析了数千例普通内科会诊。从10271例涉及18至65岁非退休患者的会诊中收集的数据，为病假开具的决定因素提供了见解。考虑了各种患者和全科医生（GP）的特征、会诊细节以及健康问题。

结果

分析的会诊中有16.5%导致了病假开具。确定了几个决定因素。老年患者获得的病假开具较少。劳动者的开具率较高，这反映了他们较差的健康状况和恶劣的工作条件。会诊时间较长与开具率较低相关。病假开具因健康问题而异，肌肉骨骼、消化、呼吸、社会和精神问题的开具率较高。

结论

了解病假开具的决定因素对于其合理使用至关重要。本研究揭示了患者特征、健康问题和全科医生因素在这些决定中的复杂相互作用。尽管该研究并非专门设计用于研究病假开具情况，且数据仅涉及相对较短的时期，即2011 - 2012年冬季，但它为病假开具提供了重要见解。更好的理解可以提高病假开具的相关性和有效性，使个人和社会都受益。有必要进行进一步的定性研究，以更详细地探讨驱动这些决定的潜在因素。