title: Sickness certification for patients with acute cough/LRTI in primary care in Poland and Norway.
abstract: OBJECTIVE
  To compare the frequency and duration of sickness certificates issued by GPs to Polish and Norwegian working adults with acute cough/lower respiratory tract infection (LRTI).
  
  
  METHODS
  Cross-sectional observational study with clinicians from nine primary care centres in Poland and 11 primary care centres in Norway. GPs filled out a case report form for all patients, including information on antibiotic prescribing, sickness certification, and advice to stay off work.
  
  
  METHODS
  Primary care research networks in Poland and Norway.
  
  
  METHODS
  Working adults with a new or worsening cough or clinical presentation suggestive of LRTI.
  
  
  METHODS
  Issuing sickness certificates and advising patients to stay off work.
  
  
  RESULTS
  GPs recorded similar symptoms and signs in patients in the two countries. Antibiotics were prescribed more often in Polish than in Norwegian patients (70.4% vs. 27.1%, p < 0.0001). About half of the patients received a formal sickness certificate (50.5% in Norway and 52.0% in Poland). The proportion of patients advised to stay off work was significantly higher in the Polish sample compared with the Norwegian sample (75.2% vs. 56.1%, p = 0.002). Norwegian GPs less often issued sick certificates for more than seven days (5.6% vs. 36.9%, p < 0.0001).
  
  
  CONCLUSIONS
  The overall proportion of sickness certification for acute cough/LRTI was similar in Norwegian and Polish patients. However, in the Polish sample, GPs more often advised patients to take time off work without issuing a sick note. When sickness certificates were issued, duration of longer than seven days was more common in Polish than in Norwegian patients.
authors.affiliation: Department of Family and Community Medicine, Medical University of Lodz, Kopcinskiego 20, Lodz,Poland. maciekgc@uni.lodz.pl
authors.forename: Maciek
authors.initials: M
authors.lastname: Godycki-Cwirko
authors.forename: Marek
authors.initials: M
authors.lastname: Nocun
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Butler
authors.forename: Magdalena
authors.initials: M
authors.lastname: Muras
authors.forename: Nils
authors.initials: N
authors.lastname: Fleten
authors.forename: Hasse
authors.initials: H
authors.lastname: Melbye
mesh_terms: D000208:Acute Disease; D000328:Adult; D003151:Community Health Centers; D003371:Cough / Q000175:diagnosis* / Q000188:drug therapy; D003430:Cross-Sectional Studies; D006801:Humans; D009664:Norway; D017063:Outcome Assessment, Health Care; D011044:Poland; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000188:drug therapy; D018582:Sick Leave; D013997:Time Factors; D014938:Work Capacity Evaluation