Beoordeling van arbeidsongeschiktheid bij SOLK*

Objective

Comparing assessments of incapacity to work in patients with subjective health complaints (SHC) by physicians from 5 different European countries.

Design

Cross-sectional study.

Method

General practitioners from Norway (n=56), Sweden (n=29), Denmark (n=41), France (n=46) and occupational and insurance physicians from the Netherlands (n=93) watched and assessed incapacity to work in nine video vignettes of patients with SHC. We subsequently analysed differences between assessments (whether or not there was incapacity to work) by country, with Norway as a reference, as well as differences between general practitioners from the four countries and occupational and insurance physicians using a generalised linear mixed model.

Results

Assessments of incapacity to work by physicians from the 5 countries were generally very similar. However, compared to Norwegian general practitioners, Swedish general practitioners (odds ratio (OR) of 0.43 with 95% confidence interval (CI) of 0.23-0.79) and Dutch occupational and insurance physicians (OR of 0.55 with 95% CI of 0.36-0.86) concluded less often that the patients in the videos were unable to work. There were no differences between general practitioners from the other 2 European countries and those from Norway. The Dutch occupational and insurance physicians also concluded less often that there was an incapacity to work compared to all general practitioners from the other 4 European countries (OR of 0.67 with 95% CI of 0.49-0.93).

Conclusion

There are significant differences between assessments of incapacity to work in patients with SHC between countries and professional groups, but these differences are generally small. Potential explanations for these differences could be found in occupational and insurance medicine specialist training and in the existence of professional guidelines.

Conflict of interest and financial support for this article: S.L. Merkus and E.L. Werner have received a research grant from the Norwegian Labour and Welfare Administration through the FARVE programme; S. Maeland and E.L. Werner have received a research grant from the Research Council of Norway (no. 187885/H20); J.P. Canévet has received a research grant and personal fees from the Agence Régionale de la Santé des Pays de la Loire; E.L. Werner has received non-financial support from The Research Unit for General Practice, Uni Research Health, Bergen, Norway. ICMJE forms provided by the authors are available online along with the full text of this article.