Sick-listing habits among general practitioners in a Swedish county

Objective - To describe sick-listing habits in general practice, how common it is and for how long and for what diagnoses it is granted. Design - Medical audit study. Setting - Primary health care. Subjects - 53 general practitioners (GPs) registering all cases during a 2- week period when sick-listing was considered. Main outcome measures - Percentage of GP consultations that involved sick-l isting, number of days of certified sick-leave, percentage of partial sick- listing, GP sex differences. Results - 9% of all consultations included a consideration about sick-listi ng, and in only 6% of these instances was a certificate not issued. The med ian length of the certified sickness period was 14 days. Musculoskeletal pr oblems were by far the most common diagnosis. Female patients were more oft en partially sick-listed than males. Female GPs sick-listed a larger propor tion of their patients than male GPs. Risk factors for long certification p eriods were in fact associated with long certification periods. Even in cas es where the GP would not recommend sick-listing a certificate was issued i n 87%. Conclusions - Patients appear to have a strong influence on sick-listing pr actice, and there are important sex differences among GPs in this practice.