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Medicina y Seguridad del Trabajo
On-line version ISSN 1989-7790Print version ISSN 0465-546X
Abstract
ALVAREZ THEURER, Esther and VAQUERO ABELLAN, Manuel. Occupational health and quality of diagnosis in the sickness absence processes. Med. segur. trab. [online]. 2009, vol.55, n.214, pp.72-79. ISSN 1989-7790.
Objective: To evaluate the quality of the diagnosis in the sick leave certificate of the sickness absence processes. Material and Method: Descriptive observational study. A sample of 1200 patients of long term sick leave (>15 days), controlled by the Medical Unit of Valuation of Disabilities (MUVD), from 1-01-2007 at 30-06-2008. Data source: sickness leaves certificates, registered in the MUVD, having the advice of the occupational medicine specialist. The quality was determined using the reliability, through the kappa index; and the agreement of the diagnosis for groups of the CIE-9-MC with the sensitivity, specificity and predictive values parameters. Results: The biggest agreement was obtained for the diagnosis group of mental diseases (kappa 0,86; standard error 0,03). The highest sensitivity took place in the diagnoses V (82,9%), XII (78,6%) and XIII (78,4%); and the positive predictive values were but high in the V (94,6%), XIII (85%) and II (85%) groups. Conclusions: The quality of the diagnosis on the sick leave certificate is acceptable. Good information to the primary health care physicians and a narrow collaboration with the occupational medicine specialist will allow to improve the quality of the diagnoses.
Keywords : quality of diagnosis; temporary disability; occupational medicine.