Explaining variations in general practitioners’ experiences of doing medically based assessments of work ability in disability benefit claims. A survey-based analysis

Abstract

Purpose: Assessing patients’ work ability is a task that many general practitioners consider challenging. Increase of mental and musculoskeletal disorders further complicate the assessments. The purpose of this paper is to explain variation between general practitioners related to how they experience the assessment of work ability in disability cases. Methods: Combining data from an original postal survey among all general practitioners in Norway (N = 1,466; response rate = 32.5%) with characteristics of the municipality where they work, we use multilevel logistic regression to estimate the relationship between a set of dependent variables measuring how confident general practitioners feel when assessing patients’ work ability in disability cases, physician-related characteristics and structural factors. Results: A main finding is that length of service explains most of the variation between general practitioners (B = 0.492 [0.015, 0.970]–2.127 [1.457, 2.798]); in most of the regressions, this variable turns out as positive and significant (p < 0.01). The general practitioners’ knowledge of possibilities of workplace adaptations in different occupations (B = 0.309 [0.026, 0.592]–0.461 [0.154, 0.768]), as well as the importance they assign to tasks related to sick-listing (B = 0.239 [0.003, 0.475]–0.639 [0.336, 0.941]), were also significantly associated with the general practitioners’ experience of assessing work capacity. The structural variables in the model provided few significant results. Conclusions: Better education and training in doing work ability assessments could be a proper measure to increase general practitioners’ confidence in doing these assessments in connection with disability benefit applications.