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G Tellnes

Publications and source records attributed to G Tellnes.

At least 19 recordsLinked to original sources
PubMed1992

[Who is long-term sick-listed in Norway? From the project Evaluation of the follow-up of long-term sick-listed].

The aim of the study was to analyse the characteristics of persons with long-term sickness certification at the end of 1990 in Norway. The study was based on data registered by the National Insurance Administration: Age, sex, place of residence, diagnoses, and prognosis as registered on Sickness certificate II. At the end of 1990 a total of 57,567 persons had been incapacitated for work for longer than eight weeks and up to 52 weeks. The prevalence was 27.9 per 1,000 employed persons, with a significantly higher prevalence among women than among men. 25% of the women certified as sick were 40-49 years old. The highest prevalence of long-term certification of sickness was found in the counties Finnmark and Troms in Northern Norway, and Hedmark in central Norway. In cases of long-term sickness certification, the most common diagnoses were musculoskeletal/connective tissue diseases and mental disorders, with a prevalence of 9.3 and 3.1 per 1,000 employed persons respectively. The study indicates the possibility of using data from existing administrative population registers to provide information on the epidemiology of long-term sickness certification in Norway. It is necessary to further improve the validity of the data.

Adult↗
PubMed1992

[ICPC in general practice].

The aim of this pilot study was to describe the distribution of diagnoses in general practice using International Classification of Primary Care (ICPC). The study took place in a group practice in Kongsberg, Southern Norway, in May 1991. It was of particular interest to find out how often doctors could use a disease as diagnosis (ICPC component 7) after the meeting with the patient and how often they used a symptom or complaint (ICPC component 1) as diagnosis. Results from 1,189 consultations show that a disease was used as diagnosis in 61% of all cases. A complaint or a symptom was used in 21%. Women were more often given a symptom as diagnosis. The study also shows that disorders of the respiratory and musculoskeletal systems were the most common diagnoses, accounting for 18% and 16% respectively. During one month, 247 diagnoses were used. Inter-observer tests of reliability showed that 81% of all consultations were coded to the same chapter.

Disease↗
PubMed1992

[What symptoms and complaints result in sick-listing? ICPC-coding of patients' own opinion in general practice].

The aim of this study was to describe which complaints patients themselves regard as the cause of sickness certification. During one week in April 1986, 1,379 patients in Buskerud county, Norway, filled in a form after receiving an initial certificate of illness or a continuation certificate from a general practitioner. International Classification of Primary Care (ICPC) no. 1-29 was used to classify the patients' symptoms and complaints. More than half of the patients (53%) considered pain in the musculoskeletal system, particularly back pain (22%), as the reason for their sickness certification. Physical work load was assumed to be a contributory cause to the complaints by 66% of the patients certified sick because of back pain, 58% of those certified sick due to cervical spine and shoulder symptoms, and 72% of those with myalgia, fibrositis (ICPC no. L18, L19). 29% of the patients meant that their health problems could have been prevented, and 15% reported that they could have continued work if their jobs had been adjusted because of their condition.

Family Practice↗
PubMed1992

[Unemployment among long-term sick-listed persons. From the project Evaluation of Follow-up of Long-term Sick-listed Persons].

The aim of the study was to compare two subgroups of patients with long-term sickness certificate, i.e. a group who were unemployed after eight weeks of incapacity for work and a group who still had a paid job at the end of the eight weeks. 712 patients who received a medical certificate II after eight weeks of incapacity for work in 1988 were followed up for another 12-15 months by means of information collected as a routine at the local National Insurance Offices in five municipalities in Norway. Of our total sample of patients, the sub-group of unemployed persons differed in a number of ways from the group who still had a job. Among the unemployed the duration of sickness certificate was longer and there were higher frequencies of mental disorders and diseases of the nervous system/sense organs. Admission to hospital was less frequent, however, among the unemployed group than among the group who still had a job. The rate of return-to-work observed after one year of sickness certificate was lower among the unemployed.

Adolescent↗
PubMed1992

[How is it going with the Sick-listing II patients? From the project Evaluation of Follow-up of Long-term Sick-listed Persons].

The aim of the study was to follow up 712 persons with respect to social insurance and labour market status one year after the start of a period of long-term sickness certificate. The study is based on information from the local National Insurance Offices in five municipalities in Norway. Mean duration of the long-term sickness certificate was 185 calendar days, slightly longer for males than females. 44.9% returned to work during the first year, another 2.9% attended vocational rehabilitation programmes, 11.7% were still receiving medical treatment, 12.2% had qualified for a disability pension, 5.6% were in receipt of an old age pension and 5.6% were unemployed. The remaining 17.1% had either died or had moved from the municipality. The few patients attending vocational rehabilitation programmes, compared with the increasing number of persons granted a disability pension in Norway since 1985 indicate insufficient effort to provide vocational rehabilitation.

Adolescent↗
PubMed1992

[Working in basic groups. From the Project Evaluation of Follow-up of Long-term Sick-listed Persons].

By 1988, all Norwegian municipalities were to have established "basic groups", i.e. interprofessional groups to guide patients in their vocational rehabilitation process. The work of these "basic groups" has been evaluated, both in terms of patients admitted for group discussions, type of actions taken and the work status of the patients one year later. The material consists of all patients admitted for basic group discussions in eight municipalities over a three months' period in the autumn 1988 (n = 261). In general the educational level of the patients was found to be low and their most common complaint was musculoskeletal/connective tissue diseases. The most frequent action suggested by the basic groups was continued medical attention. Only 11% of the patients actually attended the meeting where their situation was discussed. After a follow-up period of one year one fifth of the patients were back at their normal job, and one fourth were receiving a disability pension. Good motivation was regarded as the most important factor influencing whether the patients returned to work.

Adolescent↗
PubMed1991

[Treatment of hypertension with the ACE inhibitor lisinopril. A multicenter study of patients with mild to moderate hypertension in general practice].

367 patients with mild-moderate hypertension were included in a multicentre study for the purpose of examining the antihypertensive effect of six weeks of treatment with the ACE-inhibitor lisinopril 10 and 20 mg once daily. Both low-dose and high-dose lisinopril significantly reduced sitting and standing blood pressure values. The fall in blood pressure in the sitting position was slightly but significantly greater among the high-dose group compared with the low-dose group (a 3 mm Hg fall difference in systolic values and a 1 mm Hg fall in diastolic values). No such differences were found in the standing position. Heart rate remained unchanged during lisinopril treatment. Episodes of possible first dose hypotension were reported in six patients. Approximately 90% of the patients in both groups were classified as responders according to defined criteria. The frequency of side-effects was low, and was equal in both treatment groups. An evaluation of reduction in blood pressure, and of response rate and side-effects suggests that an initial dose of 10 mg lisinopril once daily is sufficient, and that this dosage will control blood pressure in the majority of patients.

Adult↗
PubMed1991

[Diagnoses among sick-listed pregnant women].

51% of 710 women in paid employment and resident in the municipality of Baerum were certified as sick during their gestationel period. In 1/3 of the cases the medical certificate referred to musculoskeletal/connective tissue diseases, a problem which increased with duration of pregnancy. 208 women (29%) were incapacitated from work for more than two weeks and in 36% of these women, the sickness certificate was obtained on grounds of threatened well-being of the foetus. According to the current Norwegian legislation, morbidity of the mother is the only indication for granting certification of illness to a pregnant woman. The paper indicates that the law should be updated to include morbidity of the foetus as a justifiable reason for certifying the mother as sick. In addition, the perinatal audit should be expanded to include cases of foetal morbidity as well as cases of foetal mortality.

Absenteeism↗
PubMed1990

[The sick leave notification II system. From the project Evaluation of follow-up of long-term sick leave patients].

In 1988 the National Insurance Administration in Norway introduced a compulsory sickness certificate to be issued by the doctor after eight weeks of incapacity of work (sickness certificate II). The form contains 25 specified items to be filled in by the doctor. We registered and analysed the sickness certificates received by the local National Insurance offices in five municipalities during the last three months of 1988 (n = 735). The patients included a slight majority of males. 1/3 of the patients were younger than 30 years old and 2/3 younger than 50. 1/4 of the items had not been filled in by the doctors. The most frequent diagnostic groups were musculo-skeletal/connective tissue diseases (46.4%), mental disorders (11.2%), and complications related to pregnancy and birth (9.6%). Sickness certificate II included a five-level prognosis scheme. 68.3% of the patients were allocated to prognosis A, i.e. full recovery as a result of medical treatment only. Few doctors noted that cooperation with other health and social welfare personnel was desirable. The level of unemployment was reported as being higher in patients who were certified sick for greater than or equal to 8 weeks than in the general population of the countries included in the study. The extra costs of introducing sickness certificate II are estimated to equal one day's sickness allowance for each of the 735 patients.

Absenteeism↗
PubMed1990

[Experience of cooperative groups--annual report 1988. From the project Evaluation of follow-up of long-term sick leave patients].

According to the annual reports for 1988, which all local insurance offices were instructed to send to the National Insurance Administration, interprofessional cooperation groups were regarded as a positive initiative. Only a few local offices were sceptical to the cooperation, due to local circumstances, lack of resources, or other reasons. The reports' main tendency was as expected; most of those who had their case treated in a cooperation group belonged to prognosis group B, i.e. when reeducation/rehabilitation is relevant in addition to medical treatment. The majority of the patients had been certified sick for more than 20 weeks and usually it was the local insurance office that submitted the case to the cooperation group. Local circumstances influenced the interprofessional cooperation. The labour market, communications, the location of the offices of the different professions in relation to each other, as well as clients' and group members' personal qualities led to different expressions of the cooperation from municipality to municipality and influenced the results of the work in the interprofessional cooperation groups.

Absenteeism↗
PubMed1990

Occupational factors in sickness certification.

Physical work load was assessed by doctors and patients to have contributed to the health problems leading to sickness certification in 48.4% of 1413 patients certified sick by 118 general practitioners in Buskerud county, Norway (1986). Correspondingly, psychological factors were considered contributory in 32.1%. The potential for prevention of health problems underlying sickness certificates was reported in 37.1%. As expected, the frequency of sickness certification in which physical work load and psychological factors were considered to have contributed varied with the patients' occupation, type of work, and health problem. Physical work load was assessed as contributory particularly in patients with musculoskeletal/connective tissue diseases whose work involved much walking and lifting (93.2%) or was physically strenuous (94.0%). Psychological factors were assessed as contributory in a high percentage of cases whose work was mostly sedentary. The findings indicate that the potentials for prevention as assessed by doctors and patients were highest when the health problems underlying sickness certification were associated with musculoskeletal/connective tissue diseases. The results indicate a potential for prevention and limitation of sickness certification which may be utilized by a better collaboration between community medicine and occupational health services.

Adolescent↗
PubMed1990

Inter-doctor variation in sickness certification.

Do doctor-related factors influence the duration of episodes of sickness certification? This problem was studied in an analysis of 2,999 persons certified sick by 107 general practitioners in Buskerud county, Norway, during a 4-week period in 1985. Doctors' attitudes toward sickness certification were measured by composing an index based on 12 statements (Likert scale), "weighed" by principal component analysis. Doctors' sickness certification practice was measured by duration of each episode of sickness certification. The analysis revealed no association between doctors' attitudes toward sickness certification and the duration of the episodes. Cox regression analysis showed, however, that the duration was significantly longer in patients of the oldest doctors, while it was shorter in patients of specialists in general practice and of GPs working part-time as industrial medical officers.

Adult↗
PubMed1989

[Doctors' sickness certification practice].

Sickness certification is a frequent task for doctors. The economic consequences are important for the community. One problem is that many patients have subjective symptoms that cannot be verified by objective criteria. This paper describes the history of a patient in order to illustrate some of the challenges doctors meet when they have to issue sickness certificates to patients with such illnesses. The problem underlines how important it is for doctors to know in detail the rules laid down by the National Insurance Administration. The more important rules are described in the present paper.

Adult↗
PubMed1989

[Interprofessional cooperation in the municipalities: basic groups. From the project Evaluation of the follow-up of patients with long-term sickness certification].

The Norwegian Government has decided that an interprofessional co-operation group should be established in all municipalities as from 1988. The purpose of the co-operation groups is to improve rehabilitation of patients with long-term sickness certification. The aim of the survey was to describe the establishment and function of the co-operation groups as per 1/7 1988. The local national insurance offices reported that 88% of the municipalities had started a co-operation group and 63% had held meetings. The co-operation groups were most effective in small municipalities. Activity was low in the larger towns.

Chronic Disease↗
PubMed1989

Sickness certification in general practice: a review.

Sickness certification is one of the most common tasks performed in general practice. This review describes and discusses concepts and terms used in earlier studies. 'Sickness certification' is defined, and related to the issues of 'absence from work' and 'sickness absence'. The use of measurements and results reported are emphasized according to patient- and doctor-related variables. Great variations are found, and some of the reasons may be differences in morbidity patterns, diagnostic procedures or sickness benefit acts. However, in studies from general practice, the number of sickness certificates is related to different denominators without describing the real population at risk, that is those of the patients who were employed or entitled to sickness benefits. Further studies are needed on the epidemiology of sickness certification, and the duration of the episodes. Analysis of the basis for the doctors' decisions, the patients' viewpoint, inter-doctor variations and doctors' attitudes should also be emphasized in the future. There is a need to discuss the reliability and validity of the measurements used, and theoretical considerations of the doctor's sickness certification practice are called for.

Absenteeism↗
PubMed1989

Epidemiology of sickness certification--a methodological approach based on a study from Buskerud County in Norway.

This paper is part of a broader study of doctors' "sickness certification" practice, which is correlated with, but not the same as, "sickness absence" or "sickness benefits". In order to obtain a total picture, information on sickness certification must be related to the population at risk, i.e. the epidemiology of sickness certification in a total population defined geographically. There is no routine registration system that provides statistics of sickness certification in Norway. Neither is there current information about those of the population who at any one time are entitled to sickness benefits, i.e. the population at risk. The aim of the present paper is to discuss the problems of estimating annual incidences of sickness certification, and to describe the results according to patients' sex, age, and place of residence. The study is based on all "initial certificates" received at the National Insurance Offices in Buskerud county during a period of four weeks in 1985. The population at risk was estimated at 106,019 employed persons aged 16-69 years, and the annual incidence of sickness certification at 580 per 1,000 employed persons per year (females 596, males 568). The highest incidence was found in the age group 20-29 years (females 739, males 741). In the age groups 30-39 and 40-49 years, incidences were significantly higher in females than males. The standardized incidence ratio was significantly lower than average for both females and males in agricultural municipalities, while it was significantly higher than average for females 30-39 years old in urban municipalities. The basis of epidemiological studies of sickness certification used in health services planning and in community medicine is in need of improvement. This challenge is being addressed by the National Insurance Administration in association with the Central Bureau of Statistics in Norway.

Absenteeism↗