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Leiva R, Rochaix L, Kiefer N, Dupont JCK. Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:807-821. [PMID: 33704657 PMCID: PMC8558282 DOI: 10.1007/s10926-021-09967-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
Purpose This study investigates the impact of an intensive case management program on sick leave days, permanent work incapacity levels and treatment costs for severe vocational injuries set up by the French National Insurance Fund in five health insurance districts. Methods The method employed relies on a four-step matching procedure combining Coarsened Exact Matching and Propensity Score Matching, based on an original administrative dataset. Average Treatment effects on the Treated were estimated using a parametric model with a large set of covariates. Results After one-year follow-up, workers in the treatment group had higher sickness absence rates, with 22 extra days, and the program led to 2.7 (95% CI 2.3-3.1) times more diagnoses of permanent work incapacity in the treatment group. With an estimated yearly operational cost of 2,722 € per treated worker, the average total extra treatment cost was 4,569 € for treated workers, which corresponds to a cost increase of 29.2% for the insurance fund. Conclusions The higher costs found for the treatment group are mainly due to longer sick leave duration for the moderate severity group, implying higher cash transfers in the form of one-off indemnities. Even though workers in the treated group have more diagnoses of permanent work incapacity, the difference of severity between groups is small. Our results on longer sick leave duration are partly to be explained by interactions between the case managers and the occupational physicians that encouraged patients to stay longer off-work for better recovery, despite the higher costs that this represented for the insurance fund and the well-documented adverse side effects of longer periods off-work.
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Affiliation(s)
- Rolando Leiva
- Hospinnomics (PSE - École d'Économie de Paris, Assistance Publique Hôpitaux de Paris - AP-HP) and UCL, London, UK.
| | - Lise Rochaix
- Hospinnomics (PSE - École d'Économie de Paris, Assistance Publique Hôpitaux de Paris - AP-HP), Paris, France
| | - Noémie Kiefer
- Hospinnomics (PSE - École d'Économie de Paris, Assistance Publique Hôpitaux de Paris - AP-HP), Paris, France
| | - Jean-Claude K Dupont
- Hospinnomics (PSE - École d'Économie de Paris, Assistance Publique Hôpitaux de Paris - AP-HP), Paris, France
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Franz F, Surquin M, Fantoni Quinton SF, Leroyer A. Visites de reprise pour pathologies ostéoarticulaires ou troubles mentaux en Hauts-de-France : populations concernées, actions réalisées et facteurs liés à la décision d’inaptitude. ARCH MAL PROF ENVIRO 2021. [DOI: 10.1016/j.admp.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bae SW, Oh SS, Park WM, Roh J, Won JU. Changes in Income after an Industrial Accident According to Industry and Return-to-Work Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142603. [PMID: 31336629 PMCID: PMC6678677 DOI: 10.3390/ijerph16142603] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 07/15/2019] [Accepted: 07/20/2019] [Indexed: 11/26/2022]
Abstract
Objective: To investigate changes in the incomes of workers, particularly those in the construction sector, who experienced industrial accidents according to their status of return to work. Methods: We used data from the fifth Panel Study of Workers’ Compensation Insurance. A repeated measures ANOVA was used to compare annual differential incomes before and after the industrial accident, and a linear mixed model was used to investigate the changes in income from before to after the industrial accident according to the industry and return-to-work status. Results: A comparison of the industrial categories revealed that construction industry workers exhibited the greatest incomes before the accident and the greatest decrease in income after the industrial accident. Regression analysis for assessing changes in income after the industrial accident showed that a comparison by industry revealed a significantly greater reduction in income in the construction than service industry. A comparison by work status revealed significantly greater decreases in income in the reemployment and non-return to work groups than among those who returned to their original work. Conclusions: The economic statuses of the victims of industrial accidents decreased relative to the pre-accident statuses in all industries. The ability to return to original work is important for preserving the accident victim’s economic status.
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Affiliation(s)
- Suk Won Bae
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Sarah Soyeon Oh
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Wha Me Park
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Korea
- Graduate School of Public Health, Yonsei University, Seoul 03722, Korea
| | - Jaehoon Roh
- Incheon Workers' Health Center, Incheon 21633, Korea
| | - Jong-Uk Won
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Korea.
- Graduate School of Public Health, Yonsei University, Seoul 03722, Korea.
- Incheon Workers' Health Center, Incheon 21633, Korea.
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea.
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Musti MA, Collina N, Stivanello E, Bonfiglioli R, Giordani S, Morelli C, Pandolfi P. Perceived work ability at return to work in women treated for breast cancer: a questionnaire-based study. LA MEDICINA DEL LAVORO 2018; 109:407-419. [PMID: 30556532 PMCID: PMC7682187 DOI: 10.23749/mdl.v110i6.7241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/08/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Breast cancer survivors often perceive reduced work ability upon returning to work. OBJECTIVES To identify predictors of perceived reduced work ability following return to work among women treated for breast cancer and to describe workplace interventions and support after returning to work. METHODS A questionnaire was sent to 18-65 years-old women (no. 1578) treated for breast cancer and residing in the catchment area of the Bologna Local Health Authority between 2010 and 2012. The study population was identified through a Hospital Discharge Database. The questionnaires included items about personal characteristics, cancer and work-related factors, perceived work ability and the return to work process. A multivariable logistic regression analysis was performed to identify predictors of reduced work ability upon returning to work. RESULTS Among the 841 respondents, 503 questionnaires were evaluable. In the study, 43.5% of the respondents reported reduced work ability with respect to the pre-diagnosis period. Reduced work ability was more common in non-cohabiting (OR=1.81, 95%CI 1.10-2.98) than in cohabiting/married women, and after mastectomy (OR=2.77, 95%CI 1.26-6.11) than after breast-conserving surgery. Office staff/sales assistants and managers were less likely to report reduced work ability (OR=0.51, 95%CI 0.30-0.88 and OR=0.21, 95%CI 0.06-0.76, respectively) than labourers. Women who perceived reduced work ability reported more frequently adjustment of work assignments, consultation of an occupational physician, insufficient support from employers and colleagues and discrimination. CONCLUSIONS Reduced work ability is commonly perceived among women who return to work after treatment for breast cancer. Occupational physicians and general practitioners should be aware of a wide range of factors influencing this perception in order to facilitate a successful return to work.
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Affiliation(s)
- Muriel Assunta Musti
- Unit of Epidemiology, Health Promotion and Risk Communication, Department of Public Health, Bologna Local Health Authority, Bologna, Italy.
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McGeechan GJ, McPherson KE, Roberts K. An interpretative phenomenological analysis of the experience of living with colorectal cancer as a chronic illness. J Clin Nurs 2018; 27:3148-3156. [PMID: 29752847 DOI: 10.1111/jocn.14509] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to explore the lived experiences of patients living with cancer as a chronic illness. BACKGROUND Due to recent advances in detection and treatment, cancer is now regarded as a chronic illness. However, living with cancer as a chronic illness can lead to a number of physical and psychosocial consequences all of which can lead to uncertainty over how patients view and plan for their future. DESIGN A longitudinal qualitative study. METHODS Individuals attending oncology follow-up clinics with their clinical nurse specialist at a hospital in the North East of England were invited to participate in two semistructured interviews over a 6-month period. A total of six individuals consented to participate, of whom two were women. One participant could not be contacted for the second interview, resulting in 11 interviews. Interviews were audio recorded, transcribed verbatim and analysed using interpretative phenomenological analysis. RESULTS Two super-ordinate themes emerged from the analysis: physical and psychological consequences of cancer and adapting to life after treatment. CONCLUSION The experience of future disorientation was common among participants; however, this was impacted on by a number of factors such as functional impairment and fear of recurrence. Furthermore, future disorientation does not appear to be stable and may ease as patients begin to adjust to the uncertainty of living with colorectal cancer as a chronic illness.
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Affiliation(s)
- Grant J McGeechan
- School of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Kerri E McPherson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Karen Roberts
- School of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Corbière M, Negrini A, Durand MJ, St-Arnaud L, Briand C, Fassier JB, Loisel P, Lachance JP. Development of the Return-to-Work Obstacles and Self-Efficacy Scale (ROSES) and Validation with Workers Suffering from a Common Mental Disorder or Musculoskeletal Disorder. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:329-341. [PMID: 27562583 DOI: 10.1007/s10926-016-9661-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Introduction Common mental disorders (CMDs) and musculoskeletal disorders (MSDs) lead the list of causes for work absence in several countries. Current research is starting to look at workers on sick leave as a single population, regardless of the nature of the disease or accident. The purpose of this study is to report the validation of the Return to Work Obstacles and Self-Efficacy Scale (ROSES) for people with MSDs and CMDs, based on the disability paradigm. Methods From a prospective design, the ROSES' reliability and validity were investigated in a Canadian sample of workers on sick leave due to MSDs (n = 206) and CMDs (n = 157). Results Exploratory and confirmatory factor analyses revealed that 46 items spread out on 10 conceptual dimensions (e.g., Fears of a relapse, Job demands, Difficult relation with the immediate supervisor), with satisfactory alpha coefficients and test-retest reliability for all subscales. Finally, several dimensions of ROSES also predict the participant's RTW within 6 months for MSDs (e.g., job demands), and CMDs (e.g., difficult relation with the immediate supervisor), even when adjusted by several variables (e.g., age, severity of symptoms). Apart from the job demands dimension, when the ROSES dimension is more external to the individual, only the perception of obstacles remains significant to predict RTW whereas it is the opposite result when the dimension is more internal (e.g., fears of a relapse). Conclusion The ROSES demonstrated satisfactory results regarding its validity and reliability with people having MSDs or CMDs, at the time of the return-to-work process.
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Affiliation(s)
- Marc Corbière
- Department of Education and Pedagogy, Career Counseling, Université du Québec à Montréal, Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), 1205, Rue Saint-Denis, Montréal, QC, H2X 3R9, Canada.
| | - Alessia Negrini
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du travail (IRSST), 505 Boulevard de Maisonneuve Ouest, Montréal, QC, H3A 3C2, Canada
| | - Marie-José Durand
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), School of Rehabilitation, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada
| | - Louise St-Arnaud
- Faculty of Education, Centre de Recherche et d'Intervention sur l'Éducation et la Vie au Travail (CRIEVAT), Université Laval, 2320 Rue des Bibliothèques, Québec, QC, G1V 0A6, Canada
| | - Catherine Briand
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, 7077, Avenue du Parc, Montréal, QC, H3C 3J7, Canada
| | - Jean-Baptiste Fassier
- Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE), Hospices Civils de Lyon, Université Claude Bernard Lyon 18, Avenue Rockefeller, 69673, Lyon Cedex 08, France
| | - Patrick Loisel
- Division of Occupational and Environmental Health, Dalla Lana Faculty of Public Health, University of Toronto, 155 College Street, Health Science Building, 6th floor, Toronto, ON, M5T 3M7, Canada
| | - Jean-Philippe Lachance
- School of Rehabilitation, Université de Sherbrooke, CR-IUSMM, 150 Place Charles Le Moyne, Bureau 200, Longueuil, QC, J4K 0A8, Canada
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Pélissier C, Fort E, Fontana L, Charbotel B, Hours M. Factors associated with non-return to work in the severely injured victims 3 years after a road accident: A prospective study. ACCIDENT; ANALYSIS AND PREVENTION 2017; 106:411-419. [PMID: 28728063 DOI: 10.1016/j.aap.2017.06.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 06/07/2017] [Accepted: 06/29/2017] [Indexed: 06/07/2023]
Abstract
Road accidents may impact victims' physical and/or mental health and socio-occupational life, particularly the capacity to return to work. The purpose of our study is to assess modifiable medical and socio-occupational factors of non-return to work in the severely injured 3 years after a road accident. Among1,168 road accidents casualties in the Rhône administrative Département of France followed for five years, 141 of the 222 severely injured (Maximal Abbreviated Injury Scale ≥ 3) aged more than 16 years who were in work at the time of the accident, reported whether they had returned to work in the 3 years following the accident. The subgroups of those who had (n=113) and had not returned to work (n=28) were compared for socio-occupational (gender, age, educational level, marital status, socio-occupational group) accident-related medical factors (type of road user, type of journey, responsibility in the accident, initial care) and post-accident medical factors (pain intensity, post-traumatic stress disorder, physical sequelae, quality of life) by using standardized tools. Severity of initial head, face and lower-limb injury, intense persistent pain, post-traumatic stress disorder, poor self-assessed quality of life and health status at 3 years were associated with non-return to work on univariate analysis. On multivariate analysis, severity of initial head and lower-limb injury, intense persistent pain at 3 years and post-traumatic stress disorder were significantly associated with non-return to work 3 years following severe road-accident injury. Post-traumatic stress disorder and chronic pain were essential modifiable medical determinants of non-return to work in the severely injured after a road accident: early adapted management could promote return to work in the severely injured. Improve early adapted treatment of pain and PTSD in the rehabilitation team should help the severely injured return to work following a road accident.
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Affiliation(s)
- C Pélissier
- Université de Lyon, Université Lyon 1, Université de St Etienne, IFSTTAR, UMRESTTE, UMR_T9405, 42005 Saint Etienne, France; Service de Santé au Travail, CHU de Saint-Etienne, France.
| | - E Fort
- Université de Lyon, Université Lyon 1, IFSTTAR, UMRESTTE, UMR_T9405, F-69373 Lyon, France
| | - L Fontana
- Université de Lyon, Université Lyon 1, Université de St Etienne, IFSTTAR, UMRESTTE, UMR_T9405, 42005 Saint Etienne, France; Service de Santé au Travail, CHU de Saint-Etienne, France
| | - B Charbotel
- Université de Lyon, Université Lyon 1, IFSTTAR, UMRESTTE, UMR_T9405, F-69373 Lyon, France; Hospices Civils de Lyon, Service de Santé au Travail, France
| | - M Hours
- Univ Lyon, IFSTTAR, Univ Lyon 1, UMRESTTE, UMR_T9405, F-69675 Bron, France
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Pires S, Tone F, Wloch K, Fantoni Quinton S. Utilisation et intérêt de la visite de préreprise : enquête réalisée auprès de médecins du travail. ARCH MAL PROF ENVIRO 2016. [DOI: 10.1016/j.admp.2016.03.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schneider U, Linder R, Verheyen F. Long-term sick leave and the impact of a graded return-to-work program: evidence from Germany. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2016; 17:629-43. [PMID: 26183381 DOI: 10.1007/s10198-015-0707-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 06/19/2015] [Indexed: 05/28/2023]
Abstract
The implementation of a graded return-to-work (RTW) program to reintegrate the long-term sick started in Germany in 1971 and has been manifested in the Social Code Book V since 1989. Based on a return plan by the physician and the insured, participants increase their working hours slowly over a specified period of time. As participants are still classified as incapable of working they still receive sick leave benefits. Using claims data from the Techniker Krankenkasse, the largest German sickness fund, the study aims at identifying participants and analyzing the full return-to-work and the impact of the RTW program. Thereby, we account for socio-economic factors, insurance-based characteristics, and medical and health-related information. We consider a possible selection bias by using individual weights to analyze determinants of length of the sickness absence by applying models for survival analysis (Cox proportional hazard model). As a main result - depending on the central assumption of unconfoundedness - sickness absence is positively related to participation in the RTW program for those with sickness absence longer than 120 days. For mental disorders, our results indicate an even stronger effect. The study results emphasize the need further promotion of this instrument among those insured, physicians and employers, as occupational health management is one key for a successful return-to-work.
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Affiliation(s)
- Udo Schneider
- WINEG | Scientific Institute of TK for Benefit and Efficiency in Health Care, Bramfelder Straße 140, 22035, Hamburg, Germany.
| | - Roland Linder
- WINEG | Scientific Institute of TK for Benefit and Efficiency in Health Care, Bramfelder Straße 140, 22035, Hamburg, Germany
| | - Frank Verheyen
- WINEG | Scientific Institute of TK for Benefit and Efficiency in Health Care, Bramfelder Straße 140, 22035, Hamburg, Germany
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Ruseckaite R, Collie A, Scheepers M, Brijnath B, Kosny A, Mazza D. Factors associated with sickness certification of injured workers by General Practitioners in Victoria, Australia. BMC Public Health 2016; 16:298. [PMID: 27048576 PMCID: PMC4822251 DOI: 10.1186/s12889-016-2957-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/14/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Work-related injuries resulting in long-term sickness certification can have serious consequences for injured workers, their families, society, compensation schemes, employers and healthcare service providers. The aim of this study was to establish what factors potentially are associated with the type of sickness certification that General Practitioners (GPs) provide to injured workers following work-related injury in Victoria, Australia. METHODS This was a retrospective population-based cohort study was conducted for compensation claims lodged by adults from 2003 to 2010. A logistic regression analysis was performed to assess the impact of various factors on the likelihood that an injured worker would receive an alternate/modified duties (ALT, n = 28,174) vs. Unfit for work (UFW, n = 91,726) certificate from their GP. RESULTS A total of 119,900 claims were analysed. The majority of the injured workers were males, mostly age of 45-54 years. Nearly half of the workers (49.9%) with UFW and 36.9% with ALT certificates had musculoskeletal injuries. The multivariate regression analysis revealed that for most occupations older men (55-64 years) were less likely to receive an ALT certificate, (OR = 0.86, (95%CI, 0.81 - 0.91)). Workers suffering musculoskeletal injuries or occupational diseases were nearly twice or three times at higher odds of receiving an ALT certificate when compared to fractures. Being seen by a GP experienced with workers' compensation increased the odds of receiving ALT certificate (OR = 1.16, (95%CI, 1.11 - 1.20)). Occupation and industry types were also important factors determining the type of certificate issued to the injured worker. CONCLUSIONS This study suggests that specific groups of injured workers (i.e. older age, workers with mental health issues, in rural areas) are less likely to receive ALT certificates.
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Affiliation(s)
- Rasa Ruseckaite
- Institute for Safety, Compensation and Recovery Research, Monash University, 222 Excibition St, Melbourne, Victoria, 3000, Australia.
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, The Alfred Hospital, Melbourne, Victoria, 3004, Australia.
- School of Public Health & Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Alex Collie
- Institute for Safety, Compensation and Recovery Research, Monash University, 222 Excibition St, Melbourne, Victoria, 3000, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, The Alfred Hospital, Melbourne, Victoria, 3004, Australia
| | - Maatje Scheepers
- Institute for Safety, Compensation and Recovery Research, Monash University, 222 Excibition St, Melbourne, Victoria, 3000, Australia
- Monash Injury Outcomes Unit, Monash Injury Research Institute, Monash University, Building 70, Clayton, Victoria, 3800, Australia
| | - Bianca Brijnath
- Department of General Practice, School of Primary Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia
| | - Agnieszka Kosny
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, The Alfred Hospital, Melbourne, Victoria, 3004, Australia
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario, M5G 2E9, Canada
| | - Danielle Mazza
- Department of General Practice, School of Primary Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia
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Leijon O, Josephson M, Österlund N. Sick-listing adherence: a register study of 1.4 million episodes of sickness benefit 2010-2013 in Sweden. BMC Public Health 2015; 15:380. [PMID: 25887477 PMCID: PMC4399111 DOI: 10.1186/s12889-015-1741-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/08/2015] [Indexed: 11/17/2022] Open
Abstract
Background This register study aims to increase the knowledge on how common it is that sickness benefit recipients are sick-listed for as long as their physician prescribes in their medical sickness certificate, i.e. sick-listing adherence, or wholly/partly bring return-to-work (RTW) forward, i.e. early RTW. Methods The unit for analysis was an episode of 100% sickness benefit, commenced between 1 January 2010 and 31 December 2013. Completed episodes of sickness benefit and full or partial early RTW was analysed by comparing the prescribed length of sick leave in medical sickness certificates and benefit days disbursed by the sickness insurance system. Probability for a full and partial early RTW was estimated with hazard ratio (HR) using the Cox proportional hazard model. Results In total, about 1.4 million episodes of sickness benefit (60% women) were included in the study. The overall sick-listing adherence was 84% for women and 82% for men during the first year of sick leave. Adherence varied between 82 and 87% among women and between 79 and 86% among men with regard to ICD-10 diagnosis chapter. The probability of an early RTW varied between diagnosis chapters, where mental disorders was associated with a lower probability of a full early RTW among women and men (HR 0.52 and HR 0.47) as well as a partial early RTW (HR 0.51 and HR 0.46). Younger age (16–29 years), high educational level and high income was associated with a higher probability of an early RTW, while older age (≥50 years), not native-born, low educational level, unemployment and parental leave were associated with a lower probability. Conclusion The study demonstrates that sick-listing adherence is relatively high. Probability of an early RTW differs with regard to diagnosis chapter, demographic, socioeconomic and labour market characteristics of the sickness benefit recipients. Interventions intended to improve the sick-listing process, and to affect the length and degree of sick leave in certain target groups, should include measures targeted at physicians’ sick-listing practices. Policies and economic incentives aimed at promoting RTW need to focus on individuals’ residual capacity for work.
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Affiliation(s)
- Ola Leijon
- Swedish Social Insurance Inspectorate, Box 202, SE-101 24, Stockholm, Sweden. .,Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Malin Josephson
- Swedish Social Insurance Inspectorate, Box 202, SE-101 24, Stockholm, Sweden. .,Section of Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, SE-751 85, Uppsala, Sweden.
| | - Niklas Österlund
- Swedish Social Insurance Inspectorate, Box 202, SE-101 24, Stockholm, Sweden.
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Hussain T. In this issue of Occupational Medicine. Occup Med (Lond) 2014; 64:1. [PMID: 24389898 DOI: 10.1093/occmed/kqt170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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