The quality of the sickness certificate. A case control study of patients with symptom and disease specific diagnoses in primary health care in Sweden.
Objective: To compare information in sickness certificates and rehabilitation activities for patients with symptom diagnoses vs patients with disease specific diagnoses. Design: Retrospective case control study 2013-2014. Setting: Primary health care, Sweden. Subjects. Patients with new onset sickness certificates with symptom diagnoses n?=?222, and disease specific diagnoses (controls), n?=?222. Main outcome measures: Main parameters assessed were: information about body function and activity limitation in certificates, duration of sick leave, certificate renewals by telephone, diagnostic investigations, health care utilisation, contacts between patients, rehabilitation coordinators, social insurance officers, employers and occurrence of rehabilitation plans. Results: Information about body function and activity limitation was sufficient according to guidelines in half of all certificates, less in patients with symptom diagnoses compared to controls (44% vs. 56%, p?=?0.008). Patients with symptom diagnoses had shorter sick leave than controls (116 vs. 151 days p?=?0.018) and more certificates issued by telephone (23% vs. 15% p?=?0.038). Furthermore, they underwent more diagnostic investigations (32% vs. 18%, p?