Background: Several studies have shown great differences in physicians' way to sick list. The roles of physician-related factors and local structural factors on the length of the sick leaves have been ambiguous. The aim was to examine the variation in short-term sick-listing practices among primary care physicians.
Methods: A questionnaire study with 19 hypothetical patient cases was conducted among 300 Finnish primary care physicians. The effects of both physician related and local structural background variables on sick leave prescribing were studied using univariate and multiple linear regression models. Economic consequences of the variation in sick leave prescribing were estimated.
Results: On an average, the overall number of sick leave days prescribed for the entire group of the 19 patient cases was 97.4, varying between 42 and 165 days. The economic consequences to the society of the sick leaves prescribed to them would be €29,442 on average, varying between €11,837 and €51,613. Clinical specialists prescribed shorter sick leaves than general practitioners, with estimated costs of €27,888 and €30,789, respectively. More days of sick leave was prescribed in smaller municipalities than in larger ones.
Conclusion: There is a lot of variation in physicians' sick leave prescribing practices and it depends both on physician-related factors and local structural factors. The speciality status of a physician was the most significant single factor affecting the variation. Notable savings for the society might be possible to achieve by increasing sick-listing education and training.