Sickness certification for patients with acute cough/LRTI in primary care in Poland and Norway
Sickness certification for patients with acute cough/LRTI in primary care in Poland and Norway
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DOI：
10.3109/02813432.2010.544898
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发表时间：
2011-03-01
影响因子：
2.1
通讯作者：
Melbye, Hasse
中科院分区：
文献类型：
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作者：
Godycki-Cwirko, Maciek;Nocun, Marek;Melbye, Hasse
Objective.比较波兰和挪威工作的成年人急性咳嗽/下呼吸道感染（LRTI）的全科医生签发的疾病证明的频率和持续时间。设计对来自波兰9个初级保健中心和挪威11个初级保健中心的临床医生进行的横断面观察性研究。全科医生为所有患者填写了病例报告表，包括抗生素处方信息、疾病证明和休假建议。设置.波兰和挪威的初级保健研究网络。科目新发或加重咳嗽或临床表现提示LRTI的在职成人。主要结果指标。签发疾病证明书，并建议病人不要上班。结果全科医生在这两个国家的患者中记录了相似的症状和体征。波兰患者比挪威患者更常使用抗生素（70.4% vs. 27.1%，p < 0.0001）。大约一半的病人收到了正式的疾病证明（挪威为50.5%，波兰为52.0%）。与挪威样本相比，波兰样本中建议不工作的患者比例显著较高（75.2% vs. 56.1%，p == 0.002）。挪威的全科医生很少签发超过7天的病假证明（5.6%对36.9%，p < 0.0001）。结论挪威和波兰患者中急性咳嗽/下呼吸道感染疾病证明的总体比例相似。然而，在波兰的样本中，全科医生更经常建议病人请假而不签发病假条。在开具疾病证明时，波兰患者的病程超过7天的情况比挪威患者更为常见。
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). Design. 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. Setting. Primary care research networks in Poland and Norway. Subjects. Working adults with a new or worsening cough or clinical presentation suggestive of LRTI. Main outcome measures. 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). Conclusion. 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.