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

Figures & data

Table I. Demographic and clinical characteristic of patients.

Characteristic	Poland n (%)	Norway n (%)	p
Total	125 (100)	107 (100)	NS
Male	45 (36.0)	36 (33.6)	NS
Age > 50 years	22 (17.6)	48 (44.8)	<0.0001
Smokers	56 (44.8)	30 (28.0)	<0.01
Previous illness
Respiratory comorbidity	10 (8.0)	13 (12.1)	NS
Heart comorbidity	6 (4.8)	3 (2.8)	NS
Diabetes comorbidity	1 (0.8)	8 (7.5)	0.01
Symptom presence reported by GPs in CRF^1
Cough	115 (92.0)	101 (94.4)	NS
Phlegm	52 (41.6)	48 (44.9)	NS
Abnormal phlegm (presence/absence)	27 (21.6)	39 (36.4)	0.0125
Shortness of breath	30 (24.0)	44 (41.1)	<0.01
Wheeze	19 (15.2)	21 (19.6)	NS
Coryza	64 (51.2)	41 (38.3)	<0.05
Fever	46 (36.8)	26 (24.3)	<0.05
Chest pain	25 (20.0)	26 (24.3)	NS
Muscle ache	40 (32.0)	18 (16.8)	<0.01
Headache	47 (37.6)	35 (32.7)	NS
Disturbed sleep	37 (29.6)	63 (58.9)	<0.0001
Feeling unwell	92 (73.6)	58 (54.2)	<0.01
Interference with normal activities	73 (58.4)	76 (71.0)	<0.05
Confusion	0 (0)	2 (1.9)	NS
Diarrhoea	2 (1.6)	2 (1.9)	NS
Findings
Diminished vesicular breathing	32 (25.6)	10 (9.3)	<0.002
Wheeze	29 (23.2)	31 (29.0)	NS
Crackles	13 (10.4)	18 (16.8)	NS
Rhonchi	16 (12.8)	26 (24.3)	<0.05
Temperature > 37.2°C	27 (21.6)	15 (14.0)	NS
Antibiotics prescribed	88 (70.4)	29 (27.1)	<0.0001
Working status
Full time	107 (85.6)	82 (76.6)	NS
Part time	18 (14.4)	25 (23.4)	NS
Office work	75 (60.0)	43 (40.2)	<0.01
Manual work	50 (40.0)	64 (59.8)	<0.01

Notes: Significance of differences estimated by means of chi-squared tests. ¹Reported by patients as moderate or severe problem. CRF = case report form; NS = not significant.

Figure 1. Proportions of patients issued with a sickness certificate.

Notes: Data were presented as percentage of cases related to the whole group of working adults with acute cough/LRTI from Poland (white bars, n = 125) and Norway (grey bars, n = 107). Error bars represent the 95% confidence interval (CI). #p < 0.02; *p < 0.03.

Figure 2. Patients’ attendance related to weekdays.

Notes: The percentage of work attendees visiting on different weekdays in Poland (n = 125) and Norway (n = 107) are shown as bars (in white and grey respectively) with 95% confidence interval (CI). The proportions that were sick-listed (n = 65 in Poland and n = 54 in Norway) on the different days are shown as lines.

Table II. Issuing of sickness certification according to patients’ characteristics.

Characteristic	Poland n (%)	Norway n (%)	p
All	65 (52.0)	54 (50.5)	NS
Male	23 (51.1)	19 (52.8)	NS
Female	42 (52.5)	35 (49.3)	NS
Age > 50 years	10 (45.5)	17 (35.4)	NS
Smokers	26 (46.4)	18 (60.0)	NS
Previous illness
Respiratory comorbidity	5 (50.0)	7 (53.8)	NS
Heart comorbidity	2 (33.3)	2 (66.7)	NS
Diabetes comorbidity	1 (100.0)	3 (37.5)	NS
Symptom presence reported by GPs in CRF^1
Cough	59 (51.3)	54 (53.5)	NS
Phlegm	29 (55.8)	22 (45.8)	NS
Abnormal phlegm (presence/absence)	16 (59.3)	18 (46.2)	NS
Shortness of breath	20 (66.7)	23 (52.3)	NS
Wheeze	13 (68.4)	12 (57.1)	NS
Coryza	36 (56.3)	21 (51.2)	NS
Fever	28 (60.9)	15 (57.7)	NS
Chest pain	13 (52.0)	15 (57.7)	NS
Muscle ache	18 (45.0)	12 (66.7)	NS
Headache	27 (57.4)	21 (60.0)	NS
Disturbed sleep	18 (48.6)	35 (55.6)	NS
Feeling unwell	53 (57.6)	39 (67.2)	NS
Interference with normal activities	46 (63.0)	43 (56.6)	NS
Confusion	0	0	NS
Diarrhoea	1 (50.0)	1 (50.0)	NS
Findings
Diminished vesicular breathing	13 (40.6)	2 (20.0)	NS
Wheeze	18 (62.1)	20 (64.5)	NS
Crackles	6 (46.2)	8 (44.4)	NS
Rhonchi	9 (56.3)	20 (76.9)	NS
Temperature > 37.2°C	16 (59.3)	11 (73.3)	NS
Antibiotic treatment	53 (60.2)	18 (62.1)	NS
Working status
Full time	58 (54.2)	45 (54.9)	NS
Part time	7 (38.9)	9 (36.0)	NS
Office work	42 (56.0)	22 (51.2)	NS
Manual work	23 (46.0)	32 (50.0)	NS

Notes: Data were presented as percentage related to the total number of cases in particular groups (see Table I for details). Significance of differences estimated by means of chi-squared tests. ¹Reported by patients as moderate or severe problem. CRF = case report form; NS = not significant.

Table III. Predictors of issuing a sickness certificate by GPs.

	Poland			Norway
	OR	95% CI	p	OR	95% CI	p
Male	0.52	0.17–1.62	NS	1.01	0.34–2.96	NS
Age > 50 years	0.74	0.18–3.04	NS	0.42	0.15–1.23	NS
Heart comorbidity	0.23	0.02–2.80	NS	6.95	0.24–22.92	NS
Coryza	1.56	0.49–4.98	NS	0.53	0.17–1.61	NS
Fever	1.69	0.33–8.58	NS	1.94	0.52–7.27	NS
Feeling unwell	1.38	0.39–4.91	NS	1.58	0.52–4.81	NS
Interference with activity	3.71	0.96–14.37	0.06	1.96	0.56–6.94	NS
Rhonchi	0.64	0.06–6.98	NS	10.27	2.02–52.31	0.01
Body temperature > 37.2°C	3.09	0.30–31.44	NS	4.18	0.82–21.41	NS
Antibiotic treatment	2.73	0.86–8.62	NS	1.14	0.32–4.05	NS
Part time work	0.35	0.08–1.58	NS	0.23	0.06–0.88	0.03
Manual work	1.46	0.45–4.74	NS	0.95	0.33–2.68	NS

Notes: Predictors were evaluated by using a two-level hierarchical logistic model with patients nested within clinicians, including the following variables: gender, age, auscultation abnormalities, symptoms reported by GPs at presenting day, total number of symptoms, temperature value, comorbidity (respiratory illness; heart-related diseases; diabetes), working status (manual/office; full/part time). NS = not significant.