Variation in patients’ sick leave between general practitioner practices
Variation in patients’ sick leave between general practitioner practices
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全科医生诊所之间患者病假的差异
DOI：
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发表时间：
2014
影响因子：
3.4
通讯作者：
M. Rudbeck
中科院分区：
文献类型：
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作者：
M. Rudbeck
背景：全科医生（gp）评估患者疾病的存在，判断疾病是否影响患者的工作能力，必要时建议患者请病假。我们的目的是描述5年期间全科医生（GPPs）之间患者病假的相关性。方法：对2007 - 2011年253家gpp进行研究。每个GPP的病人的个人号码都与DREAM相连，DREAM是丹麦就业部的一个登记系统，包括社会福利支付，包括病假福利。我们根据患者的年龄、性别、种族和社会差异进行了调整。采用Spearman等级相关系数（2007 - 2011）计算调整后病假的相关性。结果：GPPs之间的患者病假周数从每1000名患者36到2,704周不等（18 - 65岁）。调整后病假周数的相关系数为0.90 ~ 0.94 （P < 0.05）。病假周数最多的10个gpp和病假周数最少的10个gpp的相关性几乎与gpp总人口的相关性一样高。结论：研究显示各政府合作伙伴在病假方面存在较大差异；然而，在每个GPP中，调整病假的显著相关性被证明。这可能表明全科医生在病人的病假中起着重要的作用。本研究提供了一种在全科医生病假差异因果研究中区分低病人病假和高病人病假的gpp的方法。
Background: General practitioners (GPs) assess the existence of the patient’s disease, decide whether the disease affects the patient’s ability to work and if necessary, recommend sick leave. Our aim was to describe correlations in patients’ sick leave between GP practices (GPPs) in a 5-year period. Method: The study included 253 GPPs, from 2007 to 2011. The personal numbers of patients from each GPP were connected to DREAM, a registry at the Danish Ministry of Employment that includes social welfare payments, including sick leave benefits. We adjusted for patient age, gender, ethnicity and social differences. Spearman’s rank correlation coefficients (2007 – 2011) were used for calculating the correlation in adjusted sick leave. Results: The number of patient sick leave weeks between GPPs varied from 36 to 2,704 sick leave weeks per 1000 patients (18 – 65 years). The correlation coefficients for adjusted sick leave weeks varied from 0.90 to 0.94 (P < 0.05). Correlations for the 10 GPPs with the highest number of sick leave weeks and the 10 GPPs with the lowest number of sick leave weeks were almost as high as the correlations of the total population of GPPs. Conclusions: The study showed great differences in sick leave between GPPs; however, significant correlation for adjusted sick leave in each GPP was demonstrated. This may indicate that GPs play an important role in their patients’ sick leave. The study provides a method to distinguish between GPPs with low patient sick leave and high patient sick leave in causal studies of sick leave differences among GPs.