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Unsanctioned techniques for having sickness certificates accepted: a qualitative exploration and description of the strategies used by Swedish general practitioners
Södertörn University, School of Culture and Education, Centre for Studies in Practical Knowledge.
2019 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 1, p. 10-17Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To explore informal and unsanctioned techniques general practitioners (GPs) employ as a means to increase the likelihood of sickness certificate approval, following the Swedish Social Insurance Agency's (SSIA's) consolidation of the gatekeeping role in sickness benefit evaluation.

DESIGN: Qualitative semi-structured interviews with 20 GPs working in Swedish primary care. A thematic analysis of the transcribed material was carried out to map different techniques employed by the practitioners.

RESULTS: Eight techniques were identified, particularly with respect to the way in which the sickness certificate is written to ensure approval by the SSIA. The identified techniques were most commonly adopted when the patient's case was perceived to be at high risk for rejection by the SSIA (such as psychiatric illnesses, chronic pain etc.).

CONCLUSIONS: The findings imply that the informal and unsanctioned techniques are complex and ambiguous. They are used intentionally and covertly. The study also suggests that, while the consolidation of SSIA's gatekeeping role may have resolved some sickness absence issues, a consequence may be that GPs develop unsanctioned techniques to ensure compliance.

Place, publisher, year, edition, pages
2019. Vol. 37, no 1, p. 10-17
Keywords [en]
Family practice, Sweden, non-compliance, praxis, qualitative research, sickness certification
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:sh:diva-37543DOI: 10.1080/02813432.2019.1569426ISI: 000462849900003PubMedID: 30689481Scopus ID: 2-s2.0-85060872064OAI: oai:DiVA.org:sh-37543DiVA, id: diva2:1285959
Available from: 2019-02-05 Created: 2019-02-05 Last updated: 2019-06-11Bibliographically approved

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Shutzberg, Mani

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CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • harvard-anglia-ruskin-university
  • apa-old-doi-prefix.csl
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf