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Research Article

Sickness certification for patients with acute cough/LRTI in primary care in Poland and Norway

, , , , &
Pages 13-18 | Received 25 Jun 2010, Accepted 29 Nov 2010, Published online: 29 Dec 2010
 

Abstract

Objective. To compare the frequency and duration of sickness certificates issued by GPs to Polish and Norwegian working adults with acute cough/lower respiratory tract infection (LRTI). Design. Cross-sectional observational study with clinicians from nine primary care centres in Poland and 11 primary care centres in Norway. GPs filled out a case report form for all patients, including information on antibiotic prescribing, sickness certification, and advice to stay off work. Setting. Primary care research networks in Poland and Norway. Subjects. Working adults with a new or worsening cough or clinical presentation suggestive of LRTI. Main outcome measures. Issuing sickness certificates and advising patients to stay off work. Results. GPs recorded similar symptoms and signs in patients in the two countries. Antibiotics were prescribed more often in Polish than in Norwegian patients (70.4% vs. 27.1%, p < 0.0001). About half of the patients received a formal sickness certificate (50.5% in Norway and 52.0% in Poland). The proportion of patients advised to stay off work was significantly higher in the Polish sample compared with the Norwegian sample (75.2% vs. 56.1%, p = 0.002). Norwegian GPs less often issued sick certificates for more than seven days (5.6% vs. 36.9%, p < 0.0001). Conclusion. The overall proportion of sickness certification for acute cough/LRTI was similar in Norwegian and Polish patients. However, in the Polish sample, GPs more often advised patients to take time off work without issuing a sick note. When sickness certificates were issued, duration of longer than seven days was more common in Polish than in Norwegian patients.

Funding and ethical approval

The study data are from the GRACE project funded by the 6th Framework Programme of the European Commission under the reference LSHM-CT-2005-518226. Clinical trial no. NCT00353951. The study was approved by the ethical committee of the Medical University of Lodz and the Regional Committee for Medical and Health Research Ethics in Tromsø.

Competing interests

The authors declare no competing interests.