Sickness certification in primary care.
OBJECTIVE
Sickness certification is a common task, which is however insufficiently studied. Our objective was to describe, prospectively, prescription practices in sickness certification by primary care physicians.


METHODS
We recorded patients receiving a sickness certificate during a six-week study period. The main outcome measures were: duration of sick-leave according to age, profession, diagnosis, nationality, somatic, or psychiatric comorbidity as well as co-factors related to the familial or professional environment.


RESULTS
Out of a total of 6,433 consultations, 602 patients received a sickness certification, and in 56% of these, sick-leave duration was > or = 6 days. Multivariate analysis showed that presence of co-morbidity and co-factors, greater age and musculoskeletal, cardiovascular, psychiatric disease and injury were independently associated with a longer sickness certification duration.


CONCLUSIONS
Sickness certification is a complex task which entails not only consideration of the diagnosis but also of other factors such as co-morbidity, as well as familial and professional environment. Physicians should be aware of these elements and of situations, which might lead to a longer sick-leave period.
Dünner
S
S
Policlinique Médicale Universitaire, Lausanne.
Decrey
H
H
Burnand
B
B
Pécoud
A
A
D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D018582:Sick Leave / Q000331:legislation & jurisprudence; D013557:Switzerland; D013997:Time Factors