Abstract:
:Objective: To compare information in sickness certificates and rehabilitation activities for patients with symptom diagnoses vs patients with disease specific diagnoses. Design: Retrospective case control study 2013-2014. Setting: Primary health care, Sweden. Subjects. Patients with new onset sickness certificates with symptom diagnoses n = 222, and disease specific diagnoses (controls), n = 222. Main outcome measures: Main parameters assessed were: information about body function and activity limitation in certificates, duration of sick leave, certificate renewals by telephone, diagnostic investigations, health care utilisation, contacts between patients, rehabilitation coordinators, social insurance officers, employers and occurrence of rehabilitation plans. Results: Information about body function and activity limitation was sufficient according to guidelines in half of all certificates, less in patients with symptom diagnoses compared to controls (44% vs. 56%, p = 0.008). Patients with symptom diagnoses had shorter sick leave than controls (116 vs. 151 days p = 0.018) and more certificates issued by telephone (23% vs. 15% p = 0.038). Furthermore, they underwent more diagnostic investigations (32% vs. 18%, p < 0.001) and the year preceding sick leave they had more visits to health care (82% vs. 68%, p < 0.001), but less follow-up (16% vs. 26%, p < 0.008). In both groups contacts related to rehabilitation and with employers were scarce. Conclusion: Certificates with symptom diagnoses compared to disease specific diagnoses could be used as markers for insufficient certificate quality and for patients with higher health care utilisation. Overall, the information in half of the certificates was insufficient and early contacts with employers and rehabilitation activities were in practice missing. KEY POINTS Symptom diagnoses are proposed as markers of sickness certification quality. We investigated this by comparing certificates with and without symptom diagnoses. Certificates with symptom diagnoses lacked information to a higher degree compared to certificates with disease specific diagnoses. Regardless of diagnoses, early contacts between patients, rehabilitation coordinators and social insurance officers were rare and contacts with employers were absent.
journal_name
Scand J Prim Health Carejournal_title
Scandinavian journal of primary health careauthors
Starzmann K,Hjerpe P,Boström KBdoi
10.1080/02813432.2019.1639905subject
Has Abstractpub_date
2019-09-01 00:00:00pages
319-326issue
3eissn
0281-3432issn
1502-7724journal_volume
37pub_type
杂志文章abstract:OBJECTIVE:To explore the medically unexplained disorders by examining endpoints of irresolute diagnostic strategies. DESIGN:Qualitative observational study based on audio-taped general practice consultations, editing analysis style inspired by Giorgi's phenomenological approach. SETTING:Primary health care. SUBJECTS...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134302760234582
更新日期:2002-09-01 00:00:00
abstract::A group of 235 persons (180 adults and 55 children 0-15 years old) recorded symptoms of upper respiratory tract infection daily during two three-month periods (autumn 1986 and spring 1987). Samples for culture were taken from the nasopharynx and throat once during each period. Fifteen per cent of asymptomatic subjects...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438909088665
更新日期:1989-12-01 00:00:00
abstract:OBJECTIVE:To investigate the rate of diagnostic evaluation of dementia for patients in whom a suspicion of dementia was raised, and to investigate reasons why a diagnostic evaluation was not always being performed. DESIGN:A prospective study among elderly patients aged 65+, and a follow-up study. SETTING:In all, 17 g...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430510031324
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:To analyse how psychosocial and social factors are associated with heavy smoking in the third trimester of pregnancy. DESIGN:Data were collected from a prospective study primarily initiated to study fetal growth retardation. (NICHD Study of successive small for gestational age births). SETTING:Uppsala in Sw...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439508996759
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:The objective was to study primary healthcare patients' understanding of their diagnosis of heart failure (HF), using patients treated for diabetes mellitus (DM) as a comparative group. DESIGN:A cross-sectional community based study. SETTING:Karlskrona community situated on the Swedish south-east coast with...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430500428919
更新日期:2006-06-01 00:00:00
abstract::Insulin resistance was evaluated in 807 middle-aged subjects at a health survey, with use of an index measured in 75 g oral glucose tolerance tests. The mean value of insulin resistance was higher in a hypertensive group than among the normotensives, independent of body mass index, physical activity, smoking sex, age,...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439109026582
更新日期:1991-03-01 00:00:00
abstract::The aim of the study was to evaluate the efficiency of different strategies of intervention to reduce prescription of hypnotics/sedatives in general practice. All 356 general practitioners in the county of Aarhus, Denmark, were divided in three groups. One group received personal information at meetings, another recei...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439008994941
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:To study the effectiveness of a comprehensive diabetes programme in general practice that integrates patient-centred lifestyle counselling into structured diabetes care. Design and setting. Cluster randomised trial in general practices. INTERVENTION:Nurse-led structured diabetes care with a protocol, record ...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章,随机对照试验
doi:10.3109/02813432.2013.797178
更新日期:2013-06-01 00:00:00
abstract::The aim of the study was to describe and evaluate a controlled intervention to achieve more rational and economical drug therapy in general practice. The strategy was based on peer comparison feedback and encouragement of local peer group discussions. Seven districts comprising 53, and 6 districts comprising 55 eligib...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439209014040
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of medical audit of GPs' antibiotic prescription habits. DESIGN:Medical audit according to the APO method. Registration of antibiotic prescriptions for respiratory tract infections during a 3 year period. Intervention with courses, visits to the laboratory, and distribution of reco...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134399750002629
更新日期:1999-09-01 00:00:00
abstract::In this paper the thesis is advanced that the general practitioners can either be a powerful ally or a major roadblock in the development of primary health care in the spirit of the Alma-Ata Declaration. The role they will play depends on their interpretation of, and attitudes towards, the concept. In the first part o...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438409017705
更新日期:1984-05-01 00:00:00
abstract:OBJECTIVE:To investigate the association between serum total cholesterol and all-cause mortality in elderly individuals aged > or = 75 years. Design. A prospective cohort study with a six-year follow-up. SETTING AND SUBJECTS:A random sample (n = 700) of all persons aged > or = 75 years living in Kuopio, Finland. After...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2010.487371
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:Low plasma (p)-albumin and p-calcium concentrations are associated with increased mortality in hospitalised patients. There are few studies addressing this in primary care. Low p-calcium has been associated with mortality, but it is not known whether this applies to p-albumin. Could p-albumin and p-calcium be...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813432.2020.1843809
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:The aim was to analyse differences between female and male general practitioners (GPs) in health status and lifestyle and compared with the general population in health-related quality of life. DESIGN:A simple random sample of 1004 GPs from the whole of Sweden (71.2%) participated in a survey in May 1996 abo...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134399750002692
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:To describe the management of dyslipidaemia in patients with high risk of cardiovascular disease (CVD) and patients with a history of CVD identified by screening for diabetes in general practice in Denmark, concentrating on prescription of lipid-lowering drugs. Moreover, to analyse predicting factors for star...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813430903335216
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To develop a valid and reliable assessment tool able to measure quality of communication, patient safety and efficiency in out-of-hours (OOH) telephone triage conducted by both general practitioners (GP) and nurses. DESIGN:The Dutch KERNset tool was translated into Danish and supplemented with items from oth...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813432.2019.1568712
更新日期:2019-03-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of the study was to investigate the relationship between morbidity in early childhood and gender, birth order, and social class. DESIGN:The study used data collected in the Nijmegen Continuous Morbidity Registration. All presented morbidity and a number of personal data were available. SETTING...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439209014047
更新日期:1992-06-01 00:00:00
abstract::Self-assessed well-being has been shown to be related to earlier medical events and to be a predictor of mortality. 50-year-old men and women (n = 314) in Kungsör were invited to an examination for traditional risk factors for cardiovascular diseases and different aspects of self-assessed well-being. The differences b...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439008994950
更新日期:1990-09-01 00:00:00
abstract::Physical work load was assessed by doctors and patients to have contributed to the health problems leading to sickness certification in 48.4% of 1413 patients certified sick by 118 general practitioners in Buskerud county, Norway (1986). Correspondingly, psychological factors were considered contributory in 32.1%. The...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439008994927
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:The objectives of this study were to explore how frequently group A streptococci (GAS) were giving additional cases of clinical GAS tonsillitis within the households and to analyse predictors for such spread of GAS infection. SETTING:Two Norwegian general practice populations in Stokke and Kongsberg communit...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430410006729
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:To examine whether a Current Health scale produces reliable and valid measures of self perceived health status. DESIGN:Examination of reliability, based on internal consistency (Cronbach's alpha coefficient). Examination of validity focusing on convergent and discriminant validity. SUBJECTS:2263 male and fe...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813439508996730
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to explore whether or not the influx of patients to a GP's practice is associated with satisfaction with the GP. DESIGN:Persons in the Norwegian Living Condition Survey answered a questionnaire on satisfaction with their GP. The data on satisfaction were merged with registered inform...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813430701286579
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To assess the effect on referral rate when GPs are given a better opportunity to send their patients to specialists for consultation. DESIGN:Intervention study with a control group. SETTING AND SUBJECTS:A 34-month experiment in the City of Turku. The experimental group consisted of 10 GPs working in municip...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/028134301750235295
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to gain a deeper knowledge and understanding of experiences of antihypertensive drug treatment. DESIGN:Interview study. SETTING:A primary health care centre in western Sweden. METHOD:Qualitative interviews and analyses through systematic text condensation described by Malter...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813432.2014.982365
更新日期:2014-12-01 00:00:00
abstract::In Iceland a problem oriented medical record system for primary health care has been developed. A contact-form is used to record data on all contacts between the inhabitants in a district and the health center. A minicomputer is used for retrieval and analysis. One rural health center using this system has been succes...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438409017714
更新日期:1984-11-01 00:00:00
abstract::In an out-patient clinic for specialised medical care, 30 patients were questioned about their worries prior to the visit. The purpose of the study was to obtain basic knowledge about emotional experiences of patients visiting a doctor. The theoretical viewpoint was that of social interaction and social construction o...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438909088664
更新日期:1989-12-01 00:00:00
abstract::This study explores the diagnostic process of general practitioners confronted with ill-defined and ambiguous complaints, which eventually appeared to be caused by a malignancy. Three aspects were rated: (a) the adequacy of the initial problem definition; (b) the carefulness of further diagnostic methods; and (c) how ...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438909103670
更新日期:1989-03-01 00:00:00
abstract::The general practitioners dealing with cancer has other parameters than statistics of incidence and prevalence. In 400 consecutive interviews with patients in general practice when asked if the consultation was brought about because of fear or thoughts of cancer, eight % answered "yes" and 11% "partly". When asked if ...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.3109/02813438409017697
更新日期:1984-02-01 00:00:00
abstract:OBJECTIVE:To examine whether vaginal application of Lactobacillus casei v. rhamnosus reduces the reinfection rate in cystitis-prone women. DESIGN:A controlled, randomized, double-blind clinical trial. SETTING:Division for General Practice, University of Bergen, Norway. INTERVENTION:Vaginal application of lactobacill...
journal_title:Scandinavian journal of primary health care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.3109/02813439409029247
更新日期:1994-12-01 00:00:00
abstract:AIM:The aim of this study was to describe strategies parents use to give oral medicine to children. METHODS:We conducted an Internet-based qualitative study of posts from online forums where parents discussed how to give children oral medicine. The posts were analyzed using systematic text condensation. The investigat...
journal_title:Scandinavian journal of primary health care
pub_type: 杂志文章
doi:10.1080/02813432.2017.1333308
更新日期:2017-06-01 00:00:00