Labor Market Participation Before and After Long-Term Part-Time Sickness Absence in Finland: A Population-Based Cohort Study

Concurrent trajectories of part-time work and sickness absence: a longitudinal cohort study over 11 years among shift working hospital employees

OBJECTIVES

To investigate the concurrent changes in part-time work and sickness absence (SA) in healthcare. Another aim was to investigate the role of age and sex on different concurrent trajectory groups.

DESIGN

Prospective cohort study.

SETTING

Public hospital districts (n=10) and cities (n=11) in Finland.

PARTICIPANTS

Payroll-based objective working hour data of the healthcare sector in Finland for 28 969 employees in 2008-2019 were used. The final sample included those working shifts with 3 consecutive years of data and without baseline (≥14 days) SA.

PRIMARY OUTCOMES

Part-time work (yes or no) and months of SA.

MEASURES

Group-based trajectory modelling to identify concurrent changes in part-time work, and months of SA while controlling the time-variant amount of night work and multinomial regression models for relative risk (RR) with 95% CIs were used.

RESULTS

Four-group trajectory model was the best solution: group 1 (61.2%) with full-time work and no SA, group 2 (16.9%) with slowly increasing probability of part-time work and low but mildly increasing SA, group 3 (17.6%) with increasing part-time work and no SA, and group 4 (4.3%) with fluctuating, increasing part-time work and highest and increasing levels of SA. Men had a lower (RR 0.49-0.75) and older age groups had a higher likelihood (RRs 1.32-3.79) of belonging to trajectory groups 2-4.

CONCLUSIONS

Most of the sample were in the trajectory group with full-time work and no SA. The probability of part-time work increased over time, linked with concurrent low increase or no SA. A minor group of employees had both an increased probability of part-time work and SA. Part-time work and other solutions might merit attention to promote sustainable working life among healthcare employees.

Alternative duty work as workplace-initiated procedure to reduce sickness absence

Purpose

Alternative duty work is a procedure that enables an employee with a short-term disability to perform modified duties as an alternative to sickness absence. We examined whether the implementation of an alternative duty policy was associated with reduced sickness absence in the Finnish public sector.

Methods

Two city administrations (A and D) that implemented an alternative duty work policy to their employees (n = 5341 and n = 7538) served as our intervention cities, and two city administrations (B and C) that did not implement the policy represented the reference cities (n = 6976 and n = 6720). The outcomes were the number of annual days, all episodes, and short-term (< 10 days) episodes during the 2 years before versus the 2 years after the intervention year. We applied repeated measures negative binomial regression analyses, using the generalized estimating equations method and the difference-in-difference analysis to compare the intervention and control cities (adjusted for sex, age, type of job contract, occupational class).

Results

During the five-year study period, the number of sickness absence days and episodes increased in both the intervention and control cities. Covariate-adjusted analysis of relative risk showed that the overall increase in post- versus pre-intervention sickness absence days was smaller in intervention City A, RR = 1.14 (95% CI = 1.09–1.21) than in control cities B and C, RR = 1.19 (95% CI =1.14–1.24), group × time interaction p < 0.02. In intervention City D, we found a corresponding result regarding all sickness absence episodes and short-term sickness absence episodes but not days.

Conclusions

This follow-up suggests that implementing an alternative duty work policy may marginally decrease employees’ sickness absences.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11181-1.

Association between early working life patterns, in publicly and privately owned companies, and the course of future sickness absence due to mental disorders: a cohort study in Catalonia (Spain)

OBJECTIVES

To assess the relationship between early working life patterns, at privately and publicly held companies, and the course of sickness absence (SA) due to mental disorders.

METHODS

Cohort study of workers aged 18-28 years, affiliated with the Spanish social security system, living in Catalonia, who had at least one episode of SA due to mental disorders between 2012 and 2014. Individual prior working life trajectories were reconstructed through sequence analysis. Optimal matching analysis was performed to identify early working life patterns by clustering similar individual trajectories. SA trajectories were identified using latent class growth modelling analysis. Finally, the relationship between early working life patterns and subsequent SA trajectories was assessed via multinomial logistic regression models.

RESULTS

Among both men and women, four labour market participation (LMP) patterns were identified: stable permanent employment (reference group), increasing permanent employment, fluctuating employment and delayed employment. Among women, an increasing permanent employment pattern in early working life was related to a decrease of accumulated SA days over time (adjusted OR (aOR) 2.08; 95% CI 1.18 to 3.66). In men, we observed a trend towards a middle stable accumulation of SA days in those with fluctuating employment (aOR 1.25, 95% CI 0.57 to 2.74) or delayed employment (aOR 1.79; 95% CI 0.59 to 5.41). In both men and women, an early working life in big companies was related to a more favourable SA trajectory.

CONCLUSIONS

Early LMP patterns characterised by an increasing stability-decreased number of transitions between temporary contracts and lack of social security coverage towards permanent contracts-were related to a better future SA course due to mental diagnosis.