Patient and GP factors associated with duration of certified sickness absence
Contact - Chris Shiels; email cs50@liv.ac.uk; tel 0151 794 5968
Academic Leader
Dr Mark Gabbay
Quantitative Researchers
Chris Shiels, Mark Gabbay
Project Status
Ongoing (to Mar 2006)
Funding
NHS R&D Support Funding
Aims
1. To systematically collect sickness certification data.
2. To use such data to construct a sickness certification database
3. To investigate independent effects of patient factors upon risk of long-term work incapacity.
4. To isolate effects of GP variation on risk of long-term incapacity.
5. To investigate how GP behaviour and attitudes influence duration of certified sickness
6. To design potential interventions to reduce risk of long-term incapacity
Method
Use of carbonised sick notes to collect data at nine consortium general practices. Eighty-seven GPs (inc 45 principals) issued notes over period of 12 months. Follow-up postal survey of GPs. Sick note data and survey information merged in one database. Quantitative data analysis conducted in order to identify key factors associated with risk of long-term incapacity.
Results
Patient-based factors explain more of variation in sickness absence duration than do GP or general practice factors. Most important predictor of onset of long-term incapacity (> 28 weeks) appears to be the diagnosis on the sick note. Older age is a secondary significant factor. Mild mental disorders (MMDs), such as anxiety and depression, accounted for 40% of certified sick days. A MMD significantly increased the risk of a long-term certified sickness episode.
Published Papers
Shiels C, Gabbay M, Ford F. "Patient factors associated with duration of certified sickness absence and transition to long-term incapacity" British Journal of General Practice 2004, 54, 86-91
Conference Presentations
"Sickness Certification" (European Public Health Association Annual Meeting, Brussels, Dec 2001)
"Patient factors associated with duration of certified sickness" (Society of Academic Primary Care, ASM, Manchester, July 2003)
"Patient factors associated with duration of certified sickness and transition to long-term incapacity in the UK" (European Public Health Association Annual Meeting, Rome, Nov 2003)
"The sick role: GP and patient factors associated with long-term certification of sickness absence" (European Public Health Association Annual Meeting, Oslo, Nov 2004)
"Quantitative analysis of sick note data" (Department for Work and Pensions. London, Feb 2005)
"Understanding Fitness for Work" (International Conference on Fitness for Work. Liverpool, Mar 2005)