Can chiropractors contribute to work disability prevention through sickness absence management for musculoskeletal disorders? - a comparative qualitative case study in the Scandinavian context

PMC full text:

Published online 2018 Apr 26. doi: 10.1186/s12998-018-0184-0

Copyright/LicenseRequest permission to reuse: Copyright © The Author(s). 2018
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Table 1

Key facts relating to the chiropractors’ role in sickness absence management across Norway, Denmark, and Sweden

	Denmark	Norway	Sweden
Healthcare system
Public funding (tax-funded)	Yes	Yes	Yes
Sickness absence legislation
Certification required	No	Yes, if more than 3 days	Yes, if more than 7 days
Sickness benefits paid by employer^a	30 days	16 days	2–14 days
Sickness benefits paid by social services^a	> 30 days- 23 weeks	> 16 days −1 year	> 14 days – 1 year
Chiropractors
Sick leave certification rights	Not applicable (“fit-note”)	Yes (0–12 weeks)	No
Referral rights to imaging (e.g., x-ray or MRI) and medical specialists	Yes, partially (musculoskeletal related)	Yes, partially (musculoskeletal related)	No
Practice forms	Allied healthcare within the national healthcare system	Allied healthcare within the national healthcare system	Private musculoskeletal healthcare providers
Regulated under the national health services	Yes	Yes	Largely outside^b
Privately owned clinics	Yes	Yes	Yes
Patient fee for service	Partial	Partial	Full (private) and partial (public)^b

^aPresented are overall rules. Specifics may apply.

^bApproximately 20% of clinics have agreements under the national health services.