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Sickness certificates in Sweden : did the new guidelines improve their quality?

机译:瑞典的疾病证明:新准则是否提高了它们的质量?

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摘要

Background: Long-term sickness absence is high in many Western countries. In Sweden and many other countries, decisions on entitlement to sickness benefits and return to work measures are based on information provided by physicians in sickness certificates. The quality demands, as stressed by the Swedish sick leave guidelines from 2008, included accurate sickness certificates with assessment of functioning clearly documented. This study aims to compare quality of sickness certificates between 2007 and 2009 in Ostergotland County, Sweden. Quality is defined in terms of descriptions of functioning with the use of activity and participation according to WHOs International Classification of Functioning, Disability and Health (ICF), and in prescriptions of early rehabilitation. less thanbrgreater than less thanbrgreater thanMethods: During two weeks in 2007 and four weeks in 2009, all certificates had been collected upon arrival to the social insurance office in Ostergotland County, Sweden. Four hundred seventy-five new certificates were included in 2007 and 501 in 2009. Prolongations of sick leave were included until the last date of sick listing. Free text on functioning was analysed deductively using the ICF framework, and placed into categories (body functions/structures, activity, participation, no description) for statistical analysis. less thanbrgreater than less thanbrgreater thanResults: The majority of the certificates were issued for musculoskeletal diseases or mental disorders. Text on functioning could be classified into the components of ICF in 65% and 78% of sickness certificates issued in 2007 and 2009, respectively. Descriptions according to body components such as "sensations of pain" or "emotional functions" were given in 58% of the certificates from 2007 and in 65% from 2009. The activity component, for example "walking" or "handling stress", was more frequent in certificates issued in 2009 compared with 2007 (33% versus 26%). Prescriptions of early rehabilitation increased from 27% in 2007 to 35% in 2009, primarily due to more counseling. less thanbrgreater than less thanbrgreater thanConclusions: An improvement of the quality between certificates collected in 2007 and 2009 was demonstrated in Ostergotland County, Sweden. The certificates from 2009 provided more information linkable to ICF and incorporated an increased use of activity limitations when describing patients functioning. Still, activity limitations and prescriptions of early rehabilitation were only present in one-third of the sickness certificates.
机译:背景:在许多西方国家,长期缺勤率很高。在瑞典和许多其他国家,关于疾病补助金和恢复工作措施的决定是基于医生在疾病证明书中提供的信息。正如瑞典《 2008年病假指南》所强调的那样,对质量的要求包括准确的病假证明以及清楚记录的功能评估。本研究旨在比较瑞典Ostergotland县2007年至2009年的疾病证明质量。根据世界卫生组织《国际功能,残疾与健康分类》(ICF),根据对活动和参与的功能描述来定义质量,并根据早期康复的处方进行定义。方法:在2007年的两个星期和2009年的四个星期中,所有证明均在到达瑞典Ostergotland县的社会保险办公室后收集。 2007年包括475个新证书,2009年包括501个新证书。病假的延长被包括在内,直到病假登记的最后日期。使用ICF框架演绎了有关功能的自由文本,并将其分类(身体功能/结构,活动,参与,无描述)以进行统计分析。结果:大多数证书是针对肌肉骨骼疾病或精神障碍颁发的。在2007年和2009年颁发的疾病证书中,有关职能的文本分别可分为ICF的65%和78%。从2007年开始,有58%的证书中有对身体成分的描述,例如“疼痛感”或“情感功能”,从2009年开始,有65%的证书中有对身体成分的描述。活动成分,例如“步行”或“处理压力”与2007年相比,2009年颁发的证书更为频繁(33%比26%)。早期康复的处方从2007年的27%增加到2009年的35%,这主要是由于更多的咨询服务。结论:瑞典Ostergotland县证明2007年和2009年收集的证书之间的质量有所提高。 2009年的证书提供了更多与ICF相关的信息,并在描述患者功能时增加了活动限制的使用。但是,活动限制和早期康复的处方仅出现在三分之一的疾病证明中。

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