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Variations in primary care physicians' sick leave prescribing practices
Anni T Kankaanpää1, Jaana K Franck, Risto J Tuominen
1Department of Family Medicine, University of Turku and Turku University Hospital, Finland. atkank@utu.fi
European Journal of Public Health
|March 29, 2011
Summary
Physician prescribing of sick leave varies significantly due to physician and local factors. Specialist physicians and those in larger municipalities tend to prescribe shorter sick leaves, offering potential societal savings through targeted education.
Area of Science:
- Occupational Health
- Health Services Research
- Primary Care Medicine
Background:
- Significant variations exist in how physicians determine sick leave duration.
- The influence of physician-specific and local structural factors on sick leave length remains unclear.
Purpose of the Study:
- To investigate the variability in short-term sick leave prescribing practices among primary care physicians.
- To identify physician-related and local structural factors influencing sick leave decisions.
Main Methods:
- A questionnaire-based study involving 300 Finnish primary care physicians and 19 hypothetical patient cases.
- Univariate and multiple linear regression models were employed to analyze the impact of background variables on sick leave prescriptions.
- Economic implications of prescribing variations were estimated.
Main Results:
- Average sick leave prescribed was 97.4 days, with a wide range (42-165 days).
- Economic impact averaged €29,442 per physician group, ranging from €11,837 to €51,613.
- Clinical specialists prescribed shorter sick leaves than general practitioners, and smaller municipalities had longer sick leaves.
Conclusions:
- Physician sick leave prescribing is influenced by both individual physician characteristics and local structural factors.
- Physician specialty was the most significant factor contributing to prescribing variation.
- Enhanced sick-listing education and training could lead to substantial societal economic savings.
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