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dc.contributor.authorHoff, Eivor Hovde
dc.contributor.authorKraft, Kristian Bandlien
dc.contributor.authorMoe, Cathrine Fredriksen
dc.contributor.authorNylenna, Magne
dc.contributor.authorØstby, Kristian Amundsen
dc.contributor.authorMykletun, Arnstein
dc.date.accessioned2024-05-21T07:38:20Z
dc.date.available2024-05-21T07:38:20Z
dc.date.issued2024-02-12
dc.description.abstractBackground General practitioners (GPs) have an important gatekeeping role in the Norwegian sickness insurance system. This role includes limiting access to paid sick leave when this is not justified according to sick leave criteria. 85% of GPs in Norway operate within a fee-for-service system that incentivises short consultations and high service provision. In this qualitative study, we explore how GPs practise the gatekeeping role in sickness absence certification.<p> <p>Methods Qualitative data was collected through six focus group interviews with 33 GPs, working in practices with a minimum of four practising GPs, in different geographical regions across Norway, including both urban and rural areas. Data was analysed using Braune and Clarke’s thematic analysis approach. <p>Results Our results indicate that GPs’ sick-listing decisions are largely driven by patient demand and preferences for sick leave. GPs reported that they rarely overrule patient requests for sickness absence, including in cases where such requests conflict with the GPs’ opinion of whether sick leave is justified or benefits the patient. The degree of effort made to limit unjustified or non-beneficial sick leave seems to depend on the GPs’ available time and perceived risk of conflict with the patient. GPs generally expressed dissatisfaction with their role as certifiers of sickness absence. <p>Conclusion Our study suggests that GPs’ decisions about sickness certification is largely driven by patient preferences. The GPs’ gatekeeping function is limited to negotiations about grade and duration of absence spells.en_US
dc.identifier.citationHoff, Kraft, Moe, Nylenna, Østby, Mykletun. The cost of saying no: general practitioners’ gatekeeping role in sickness absence certification. BMC Public Health. 2024;24(1)en_US
dc.identifier.cristinIDFRIDAID 2252316
dc.identifier.doi10.1186/s12889-024-17993-1
dc.identifier.issn1471-2458
dc.identifier.urihttps://hdl.handle.net/10037/33577
dc.language.isoengen_US
dc.publisherBMCen_US
dc.relation.journalBMC Public Health
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2024 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleThe cost of saying no: general practitioners’ gatekeeping role in sickness absence certificationen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's license is described as Attribution 4.0 International (CC BY 4.0)