Work ability and duration of certified sickness absence

Abstract

Aims: The aim of this study was to examine the association between assessed work ability and the duration of certified sickness absence. Methods: A total of 549 patients and 52 doctors provided questionnaire data about 549 episodes of absence. The episodes were classified as new, one month, or three months according to their duration at the time of questionnaire completion. Their duration after that was used as outcome. Uni-and multivariate Cox regression analyses were performed. Results: In the multivariate analyses, a ``very much reduced' ' work ability assessed by patients was associated with a longer duration than a ``moderately reduced' ' work ability, in both one- and three-month episodes. Musculoskeletal and psychological disorders were associated with a longer duration, and respiratory disorders with a shorter duration than other disorders in new episodes. Patient age above 50 years was associated with a longer duration than lower age in new and three-month episodes. The doctors' use of referral and tests in the consultations, and the presence of non-medical factors as judged by the patients, were associated with a longer duration than the absence of those factors in new episodes. The patients' degree of job satisfaction, and non-medical factors as judged by doctors, were significantly associated with duration only in univariate Cox regression analyses in new episodes. Work demands were not significantly associated with duration in any of the analyses. Conclusions: Work ability assessed by patients may be a useful prognostic indicator of duration in prolonged episodes of certified sickness absence. Further studies using other outcomes, such as disability pensioning, would be of interest to enlighten the concepts of work ability.

Keywords

duration epidemiology functional assessment sick leave sick listing sickness absence sickness certification work ability.

References

Tellnes G. Sickness certification in general practice: a review. Fam Pract 1989; 6: 58-65.

Brage S. , Nygård JF , Tellnes G. The gender gap in musculoskeletal-related long term sickness absence in Norway . Scand J Soc Med 1998; 26: 34-43.

Tellnes G. Duration of episodes of sickness certification. Scand J Prim Health Care 1989; 7: 237-44.

Haaland EMH , Indahl A. , Ursin H. Patients with low back pain not returning to work. A 12-month follow-up study . Spine 1998; 23: 1202- 8.

Lemeshow S. , Letenneur L. , Dartigues J-F. , Lafont S. , Orgogozo J-M. , Commenges D. Illustration of analysis taking into account complex survey considerations: the association between wine consumption and dementia in the PAQUID study . Am J Epidemiol 1998; 148: 298-306.

Reiso H. , Nygård JF , Brage S. , Gulbrandsen P. , Tellnes G. Work ability assessed by patients and their GPs in new episodes of sickness certification. Fam Pract 2000; 17: 138-43.

Brage S. , Bentsen BG , Bjerkedal T. , Nygård JF , Tellnes G. ICPC as a standard classification in Norway. Fam Pract 1996; 13: 391-6.

ICPC - International Classification of Primary Care, short version. RTV form 3.12.c. of October 1992, changed May 1994. Oslo : National Insurance Administration, 1994. (In Norwegian.)

The Norwegian Directorate of Labour. Classification of occupations. List of occupations with NCO codes (Nordic Classification of Occupations). Oslo: The Norwegian Directorate of Labour, 1989. (In Norwegian.)

10.

Tellnes G. , Svendsen KOB , Bruusgaard D. , Bjerkedal T. Incidence of sickness certification. Proposal for use as a health status indicator . Scand J Prim Health Care 1989; 7: 111-17.

11.

Ljungdahl LO , Bjurulf P. The accordance of diagnoses in a computerized sick-leave register with doctors' certificates and medical records. Scand J Soc Med 1991; 19: 148-53.

12.

Tellnes G. , Sandvik L. , Moum T. Inter-doctor variation in sickness certification. Scand J Prim Health Care 1990; 8: 45- 52.

13.

Hensing G. , Spak F. , Alexanderson K. , Allebeck P. Sick-leave among women and the role of psychiatric disorder. Scand J Soc Med 1997; 25: 185-92.

14.

Ilmarinen J. , Tuomi K. , Klockars M. Changes in the work ability of active employees over an 11-year period. Scand J Work Environ Health 1997; 23 (suppl 1): 49- 57.

15.

Tuomi K. , Ilmarinen J. , Setsamo J. , Huuhtanen P. , Martikainen R. , Nygård CH , et al. Summary of the Finnish research project ( 1981-1992 ) to promote the health and working ability of ageing workers. Scand J Work Environ Health 1997; 23 (suppl 1): 66-71.

16.

Eskelinen L. , Kohvakka A. , Merisalo T. , Hurri H. , Wägar G. Relationship between the self-assessment and clinical assessment of health status and work ability . Scand J Work Environ Health 1991; 17 (suppl 1): 40- 7.

17.

Fylkesnes K. , Fø rde OH. The Tromsø study: predictors of self-evaluated health - has society adopted the expanded health concept? Soc Sci Med 1991; 32: 141-6.

18.

Ostlin P. Occupational history, self reported chronic illness, and mortality: a follow up of 25,586 Swedish men and women. J Epidemiol Community Health 1990; 44: 12- 16.

19.

Miilunpalo S. , Vuori I. , Oja P. , Pasanen M. , Urponen H. Self-rated health status as a health measure: the predictive value of self-reported health status on the use of physician services and on mortality in the working-age population . J Clin Epidemiol 1997; 50: 517-28.

20.

Lundberg O. , Manderbacka K. Assessing reliability of a measure of self-rated health. Scand J Soc Med 1996 ; 24: 218-24.

21.

Manderbacka K. Methods.

How do respondents understand survey questions on ill-health?

Eur J Public Health 1998; 8: 319-24.

22.

Swales K. , Craig P. Evaluation of the Incapacity Benefit Medical Test. In-house report 26. London: Social Research Branch, Analytical Services Division, Department of Social Security, 1997.

23.

Karasek R. , Theorell T. Healthy work: stress, productivity and the reconstruction of working life . New York: Basic Books, 1990.

24.

Westin S. Becoming disabled: a sociomedical analysis of individual adaptations to life after long-term unemployment [dissertation]. Trondheim : The Royal Norwegian Society of Sciences and Letters , No. 2, 1990.

25.

Luz J. , Green MS Sickness absenteeism from work - a critical review of the literature . Public Health Rev 1997; 25: 89- 122.

26.

North FM , Syme SL , Feeney A. , Shipley M. , Marmot M. Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study. Am J Public Health 1996; 86: 332-40.

27.

Hemingway H. , Shipley MJ , Stansfeld S. , Marmot M. Sickness absence from back pain, psychosocial work characteristics and employment grade among office workers. Scand J Work Environ Health 1997; 23: 121-9.

28.

Marmot M. , Feeney A. , Shipley M. , North F. , Syme SL Sickness absence as a measure of health status and functioning: from the UK Whitehall II Study. J Epidemiol Community Health 1995; 49: 124-30.

29.

Vahtera J. , Pentti J. , Uutela A.

The effect of objective job demands on registered sickness absence spells: do personal, social and job-related resources act as moderators?

Work and Stress 1996; 10: 286-308.

30.

Tellnes G. , Bruusgaard D. , Sandvik L. Occupational factors in sickness certification. Scand J Prim Health Care 1990; 8: 37-44.

31.

Van der Weide WE , Verbeek JH , Salle HJ , van Dijk FJ Prognostic factors for chronic disability from acute low-back pain in occupational health care . Scand J Work Environ Health 1999; 25: 50- 6.