Explaining variations in general practitioners’ experiences of doing medically based assessments of work ability in disability benefit claims. A survey-based analysis

Figures & data

Table 1. Representativeness of sample. Proportion in population compared with proportion in sample (per cent)

Variable		Population (%)	Sample (%)	Difference (pp)
Gender	Male	62.4	64.9	2.5
	Female	37.6	35.1	−2.5
Age	< 30 years/ ≤ 30 years	1.5	1.9	0.4
	30–39/31–40	26	27.0	1.0
	40–54/41–50	37.2	20.6	−16.6
	55–66/51–60	21.7	31.4	9.7
	–/61–70	–	18.4	–
	≥ 67/ ≥ 71 years	2.6	0.7	−1.9
Number of patients per list (mean)		1,164	1,211	47
Local population size	≤ 4,999 inhabitants	10.8	10.0	−0.7
	5,000–9,999	14.9	13.1	−1.9
	10,000–19,999	16.3	16.9	0.6
	20,000–49,999	23.0	24.6	1.6
	≥ 50,000	35.0	35.4	0.4
N		4,279	1,435

Note: pp = percentage point. Information on gender, age, and average number of patients in the population of GPs is from 31 December 2012 and was collected from the Directorate of Health’s statistics on GPs in Norway. Note that the age intervals reported by the Directorate of Health differs somewhat from the age intervals in the survey, which limits comparability particularly for the middle categories.

Source: Official statistics from the Directorate of Health, “General practitioners 2012. Main numbers”, Table 1, by Per Øivind Gaardsrud, https://helsedirektoratet.no/statistikk-og-analyse/fastlegestatistikk#fastlegestatistikk-2012 [Accessed 1 November 2016].

Table 2. Empirical results based on mixed-effect logistic regression. Logistic regression coefficients, 95% confidence intervals (CI) and p-values

		Level of confidence			GP – patient relation		Lenience
		I feel confident with the medical assessments I do in connection with disability applications	I find it difficult to assess functional capacity in connection with disability applications (reversed)	Assessing medical aspects of disability is particularly difficult in cases involving mental diagnoses (reversed)	Patients who have concluded that disability is an option, are difficult to motivate to further investigation of functional ability (reversed)	Patients have an opinion of their own disability that diverges from mine (reversed)	When I fill out a medical certificate of work disability I recommend a disability degree
Male		−0.161 [−0.479, 0.158]	−0.025 [−0.295, 0.244]	0.224 [−0.043, 0.491]	−0.254* [−0.506, −0.002.]	−0.421** [−0.728, −0.114]	−0.110 [−0.357, 0.136]
Patient volume		−0.000 [−0.002, 0.002]	−0.001 [−0.002, 0.001]	−0.000 [−0.002, 0.001]	−0.001 [−0.003, 0.000]	−0.003** [−0.005, −0.002]	−0.001 [−0.002, 0.000]
Specialization in general medicine		0.061 [−0.378, 0.500]	−0.128 [−0.506, 0.250]	−0.036 [−0.406, 0.333]	−0.224 [−0.570, 0.123]	0.119 [−0.286, 0.523]	0.133 [−0.205, 0.471]
Length of service as a GP	6–10 years	1.262** [0.750, 1.773]	0.852** [0.415, 1.289]	0.285 [−0.201, 0.771]	0.523* [0.074, 0.972]	0.492* [0.015, 0.970]	0.388 [−0.040, 0.815]
	11–20 years	1.638** [1.100, 2.176]	1.571** [1.102, 2.040]	0.801** [0.329, 1.272]	0.676** [0.233, 1.119]	0.863** [0.366, 1.360]	0.737** [0.311, 1.163]
	21–30 years	1.976** [1.398, 2.554]	1.600** [1.125, 2.075]	0.907** [0.431, 1.382]	0.799** [0.350, 1.248]	1.261** [0.732, 1.791]	0.809** [0.378, 1.239]
	> 30 years	2.127** [1.457, 2.798]	1.616** [1.092, 2.139]	0.556* [0.044, 1.068]	0.753** [0.272, 1.235]	1.110** [0.541, 1.678]	0.749** [0.284, 1.214]
Knowledge of adaptation opportunities		0.461** [0.154, 0.768]	0.189 [−0.069, 0.446]	0.002 [−0.247, 0.250]	0.439** [0.199, 0.680]	0.309* [0.026, 0.592]	0.131 [−0.103, 0.365]
Sick leave tasks important part of my job		0.639** [0.336, 0.941]	0.535** [0.280, 0.791]	0.042 [−0.210, 0.294]	0.235 [−0.010, 0.480]	0.550** [0.269, 0.831]	0.239* [0.003, 0.475]
Population size	5,000–9,999	−0.786* [−1. 459, −0.113]	−0.246 [−0.798, 0.306]	0.419 [−0.104, 0.941]	−0.038 [−0.521, 0.445]	0.032 [−0.587, 0.650]	−0.041 [−0.539, 0.456]
	10,000–19,999	−0.914** [−1.568, −0.261]	−0.417 [−0.946, 0.113]	−0.015 [−0.538, 0.508]	−0.296 [−0.771, 0.180]	−0.207 [−0.791, 0.376]	−0.228 [−0.718, 0.262]
	20,000–49,999	−0.758* [−1.428, −0.088]	−0.463 [−0.993, 0.067]	0.033 [−0.492, 0.557]	−0.112 [−0.579, 0.355]	0.031 [−0.567, 0.629]	0.085 [−0.415, 0.584]
	≥ 50,000	−0.345 [−1.083, 0.394]	−0.273 [−0.854, 0.308]	0.139 [−0.442, 0.720]	0.203 [−0.307, 0.714]	−0.034 [−0.697, 0.629]	0.402 [−0.177, 0.980]
Disability rate (%)		0.012 [−0.065, 0.089]	−0.008 [−0.067, 0.052]	−0.069* [−0.135, −0.002]	0.021 [−0.033, 0.076]	−0.010 [−0.080, 0.060]	0.008 [−0.056, 0.072]
Unemployment rate (%)		0.216 [−0.115, 0.547]	0.174 [−0.082, 0.429]	−0.116 [−0.398, 0.166]	−0.204 [−0.435, 0.028]	−0.096 [−0.409, 0.217]	−0.227 [−0.505, 0.051]
Intercept		−0.198 [−1.305, 0.908]	−0.238 [−1.154, 0.679]	−0.695 [−1.620, 0.229]	−0.562 [−1.419, 0.296]	1.748** [0.718, 2.778]	−0.169 [−1.068, 0.729]
N1		1,355	1,345	1,348	1,345	1,353	1,348
N2		274	275	275	275	274	274

Notes: “Reversed” indicates that items were reversed for ease of comparison, so that 1 corresponds to a more positive experience.

* p < 0.05.

** p < 0.01.