66 Medical certification of injured workers by General Practitioners in the state of Victoria, Australia: A descriptive study
研究了2003-2010年维多利亚州全科医生为受伤工人开具医疗证明的模式，发现多数证明为“不适合工作”，其中精神疾病类证明比例最高，提示全科医生在帮助工人返岗中可能起重要作用。
<h3>Objectives</h3> To describe the medical certification practices of General Practitioners (GPs) in their interactions with injured workers receiving compensation under Victorian workers’ compensation scheme over the period 2003–2010 in Victoria, Australia <h3>Methods</h3> Compensation research database, containing workers’ compensation administrative claims data and medical certification information was accessed to extract data for the period 2003 to 2010 for males and females. All claimants, 15–65 years of age with ‘lost-time’ claims only were included into analysis. Only the initial certificates were analysed. Medical certificates were divided into three groups: “unfit for work”, “alternate duties” and “fit for work”. Injuries and diseases were categorised into fractures, musculoskeletal (MSK) injuries and diseases, other (non MSK) traumatic injuries, back pain and strains, mental disorders and other diseases. <h3>Results</h3> Over the period of 2003–2010 a total of 9,750 GPs issued 124,424 medical certificates to the injured workers. The majority of certificates (40.2%) were for MSK injuries and diseases, followed by back pain and strains (16.4%) and other traumatic injuries (15.6%). Almost two thirds of all certificates were issued to males; however in the mental disease category more than 50% of certificates were written to females. The vast majority of certificates (>74%) were “unfit for work”, with 94% of them being for mental disorders. This is in contrast to the findings for MSK injuries and disorders (68.0%) or other diseases (53.0%). The duration of “alternate duties” certificates was ~4 days longer than “unfit for work”. <h3>Conclusions</h3> This was the first of planned analyses examining the medical certification practices of GPs. It already demonstrates different certification patterns and suggests that GPs may play an important role in returning injured workers back to work. Future analyses will examine changes in GP certification practices over time and patterns of health service utilisation by injured workers following medical certification.