LAUSR

Sickness certification guidelines, introduced in Sweden 2007, are to support physician’s work with sickness certification of patients. Our aim was to explore the clinical importance of the guidelines, by studying what kind of information from guidelines the physicians use, and if this differ between type of clinics. Data from a questionnaire sent to all 34 718 physicians in Sweden in 2017 were used (54% response rate). The study is based on answers from the 13 750 physicians who had sick-leave consultations. Half of the respondents used the guidelines at least once a month, and this was most common in primary healthcare (72%), occupational health services (64%) and psychiatry (61%). The type of information used differed; 53% used recommendations about suggested sick-leave duration and 29% about degree (full- or part-time) of sickness absence. Using information about function respectively work capacity was more common within psychiatry (42 and 42%), primary healthcare (37 and 38%) and occupational health services (35 and 41%) and less common among physicians in surgery and orthopaedic clinics (12 and 12%) who more often used information about duration (48 and 53%). In total, 74% reported that the guidelines to some extent were problematic to apply while 29% reported that they improved the quality of how they handled sickness certification tasks. Half (47%) experienced that the guidelines facilitated their contacts with patients. The use of sickness certification guidelines varied between type of clinic and a majority experienced to some extent that the guidelines were problematic to apply. Further studies are needed to assess what information physicians in different settings need and what developments of the guidelines that are warranted. Half of the physicians used the sickness certification guidelines every month, but the type of information used varied with type of clinical setting. As many as half of the physicians stated that the sickness certification guidelines facilitated their contacts with patients, but a majority found them somewhat problematic to apply.