Short-term sick leave certification for minor illness in the outpatient setting



Department of Outpatient, Ministry of health, Brunei Darussalam



Introduction: Sick leave is one of the key concepts of social health protection defined by various International Labour Organisations. However it has repercussions to the economy with lost man-hours and productivity if abused. In Brunei Darussalam, sick leave are certified and issued by both government and private doctors wherein general practitioners (GPs) make-up the majority of prescribers. However with a virtually free healthcare and continuing presence of ‘Flu clinic’, this has put considerable strain and unwanted pressure especially on government GPs. Materials and Methods: Using a self-designed questionnaire for both patients and GPs, 371 patients and all GPs from two health centres were included over a study period of two weeks. Results: Of the 371 patients studied, 310 patients needed sick leave but only 87 patients actually warranted sick leave based on their medical condition. 188 patients (50.7%) requested for two-day sick leave but only nine patients (2.4%) were actually given two days sick leave. Majority of patients were prescribed only one-day sick leave regardless of diagnosis of minor illnesses. Sick leave was more likely to be given to patients with low education level, unskilled jobs, low salary and patients doing ‘office hour’ work. Peak days of sick certification were Monday and Saturday. Most patients prefer the current sick leave system and do not want a self-certification system. Conclusion: This study showed that a majority of patient did not warrant sick leave based on the GP’s assessment. Despite this, a large proportion was given one-day sick leave.


Keywords: Sick leave certification, self-certification, minor illness, outpatient department


Correspondence author: Munir METASSAN, Primary Health Care, Ministry of Health, Brunei Darussalam.

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Brunei Int Med J. 2016; 12 (2): 52-59