title: Sick-leave decisions for patients with severe subjective health complaints presenting in primary care: a cross-sectional study in Norway, Sweden, and Denmark.
abstract: OBJECTIVE
  The primary objective of this study was to explore whether general practitioners (GPs) in Norway, Sweden, and Denmark make similar or different decisions regarding sick leave for patients with severe subjective health complaints (SHC). The secondary objective was to investigate if patient diagnoses, the reasons attributed for patient complaints, and GP demographics could explain variations in sick leave decisions.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Video vignettes of GP consultations with nine different patients.
  
  
  METHODS
  126 GPs in Norway, Sweden, and Denmark.
  
  
  METHODS
  Primary care in Norway, Sweden, and Denmark.
  
  
  METHODS
  Sick leave decisions made by GPs.
  
  
  RESULTS
  "Psychological" diagnoses in Sweden were related to lower odds ratio (OR) of granting sick leave than in Norway (OR = 0.07; 95% CI = 0.01-0.83) Assessments of patient health, the risk of deterioration, and their ability to work predicted sick leave decisions. Specialists in general medicine grant significantly fewer sick leaves than non-specialists.
  
  
  CONCLUSIONS
  Sick-leave decisions made by GPs in the three countries were relatively similar. However, Swedish GPs were more reluctant to grant sick leave for patients with "psychological" diagnoses. Assessments regarding health-related factors were more important than diagnoses in sick-leave decisions. Specialist training may be of importance for sick-leave decisions.
authors.affiliation: Uni Health, Uni Research , Bergen , Norway.
authors.forename: Silje
authors.initials: S
authors.lastname: Maeland
authors.forename: Erik L
authors.initials: EL
authors.lastname: Werner
authors.forename: Marianne
authors.initials: M
authors.lastname: Rosendal
authors.forename: Ingibjorg H
authors.initials: IH
authors.lastname: Jonsdottir
authors.forename: Liv H
authors.initials: LH
authors.lastname: Magnussen
authors.forename: Stein Atle
authors.initials: SA
authors.lastname: Lie
authors.forename: Holger
authors.initials: H
authors.lastname: Ursin
authors.forename: Hege R
authors.initials: HR
authors.lastname: Eriksen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003657:Decision Making; D003718:Denmark; D059026:Diagnostic Self Evaluation; D005260:Female; D058005:General Practitioners / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D008875:Middle Aged; D009664:Norway; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012720:Severity of Illness Index; D018582:Sick Leave / Q000706:statistics & numerical data*; D013548:Sweden; D014938:Work Capacity Evaluation