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Scand J Prim Health Care. 2011 Jun;29(2):110-6. doi: 10.3109/02813432.2011.555382. Epub 2011 Feb 17.

Decisions on sick leave certifications for acute airways infections based on vignettes: a cross-sectional survey of GPs in Norway and Poland.

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General Practice Research Unit, Department of Community Medicine, University of Tromsø, Norway.


OBJECTIVE. To explore whether frequency and duration of sick-leave certification for acute airway infections differ between general practitioners (GPs) in Poland and Norway. DESIGN. Cross-sectional survey. SETTING. Educational courses for GPs. Intervention. We used a questionnaire with four vignettes presenting patients with symptoms consistent with pneumonia, sinusitis, common cold, and exacerbation of chronic obstructive pulmonary disease (COPD), respectively. For each vignette GPs were asked whether they would offer a sick-leave note, and if so, for how many days. Subjects. Convenience samples of GPs in Poland (n = 216) and Norway (n = 171). MAIN OUTCOME MEASURES. Proportion of GPs offering a sick-leave certificate. Duration of sick-leave certification. Results. In Poland 100%, 95%, 87%, and 94% of GPs would offer sick leave for pneumonia, sinusitis, common cold, and exacerbation of COPD, respectively. Corresponding figures in Norway were 97%, 83%, 60%, and 90%. Regression analysis adjusting for the GPs' sex, speciality, experience, and workload indicated that relative risks for offering sick leave (Poland versus Norway) were 1.16 (95% CI 1.07-1.26) for sinusitis and 1.50 (1.28-1.75) for common cold. Among GPs who offered sick leave for pneumonia, sinusitis, common cold, and exacerbation of COPD, mean duration was 8.9, 7.5, 5.1, and 6.9 days (Poland) versus 6.6, 4.3, 3.1, and 6.1 days (Norway), respectively. In regression analyses the differences between the Polish and Norwegian samples in duration of sick leave were statistically significant for all vignettes. A pattern of offering sick leave for three, five, seven, 10, or 14 days was observed in both countries. CONCLUSION. In the Polish sample GPs were more likely to offer sick-leave notes for sinusitis and common cold. GPs in Poland offered sick leaves of longer duration for pneumonia, sinusitis, common colds, and exacerbation of COPD compared with GPs in the Norwegian sample.

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