Utilisation of nationwide register data to assess the effectiveness of changes in sickness insurance legislation on work participation and analyse sickness absence and disability retirement trends in Finland

2018 ◽  
Vol 26 (7) ◽  
pp. 334-339 ◽  
Author(s):  
Eira Viikari-Juntura ◽  
Taina Leinonen ◽  
Lauri Virta ◽  
Kirsti Husgafvel-Pursiainen ◽  
Mikko Laaksonen ◽  
...  
2019 ◽  
Vol 76 (6) ◽  
pp. 363-369 ◽  
Author(s):  
Maria Sirén ◽  
Eira Viikari-Juntura ◽  
Jari Arokoski ◽  
Svetlana Solovieva

ObjectiveTo examine the impact of a disabling non-traumatic shoulder lesion on work participation and working life expectancy.MethodsFrom a 70% random sample of the Finnish population, we selected 30–59-year-old wage earners with prolonged sickness absence due to a shoulder lesion (n=7644). We followed the persons from 2006 to 2014 and calculated the proportion of time a person spent in different work participation statuses. The associations of potential determinants with a preterm exit from paid employment were tested using Cox regression. Years expected to be spent in different work participation statuses were estimated applying the Sullivan method for healthy life expectancy.ResultsDuring 9 years of follow-up time spent at work was reduced from 77.7% to 46.7%, and 15.8% of the persons were granted disability retirement, mostly due to shoulder and other musculoskeletal diseases. Compared with the general population persons with a disabling shoulder disease are expected to lose from 1.8 to 8.1 years of working life, depending on their age. Age, gender, education, duration of initial sickness absence due to the shoulder lesion, not being able to return to work sustainably and participation in vocational rehabilitation predicted preterm exit from work. Heavy lifting increased the risk of preterm exit marginally.ConclusionsWorking life expectancy is markedly reduced in persons with a disabling shoulder lesion, mainly because of disability retirement due to musculoskeletal problems. Clinicians should consider interventions targeted at improving musculoskeletal functioning and necessary work modifications before shoulder problems become chronic or the persons develop disabling comorbid musculoskeletal conditions.


2008 ◽  
Vol 65 (1) ◽  
pp. 61-67 ◽  
Author(s):  
M Voss ◽  
S Stark ◽  
L Alfredsson ◽  
E Vingard ◽  
M Josephson

Public Health ◽  
2016 ◽  
Vol 133 ◽  
pp. 75-82 ◽  
Author(s):  
A.H. Momsen ◽  
C.V. Nielsen ◽  
M.B.D. Nielsen ◽  
R. Rugulies ◽  
C. Jensen

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A75.3-A76
Author(s):  
Taina Leinonen ◽  
Eira Viikari-Juntura ◽  
Kirsti Husgafvel-Pursiainen ◽  
Pirjo Juvonen-Posti ◽  
Mikko Laaksonen ◽  
...  

IntroductionResearch on the effectiveness of vocational rehabilitation has often focused on small and selected groups of rehabilitees, lacked proper controls, or not captured dynamic changes in work participation. Using rich nationwide data on vocational rehabilitees and their matched controls, we examined long-term changes in work participation before and after vocational rehabilitation to assess its effectiveness.MethodsWe used representative Finnish register data to examine 2692 recently employed individuals with histories of musculoskeletal- and mental-related work disability who started vocational rehabilitation in 2008–2010 at age 30–55 (intervention group), and 2692 propensity score matched non-rehabilitees who otherwise met the same criteria (control group). Matching was performed based on sociodemographic and work-related factors, work disability diagnosis, and three-year labour market history. We used generalised estimation equations to examine differences in the proportion of time spent at work between periods of three years before and three years after rehabilitation among the intervention and control group and the difference in these differences (DID).ResultsAmong those with 105+days of work disability in the preceding three-year period, vocational rehabilitation resulted in significant percentage point gains in work participation, with the total DID across the disease groups and genders being 9.2 (95% confidence interval 7.3–11.1). The gains tended to actualise immediately after rehabilitation. No gains were observed among those with shorter preceding work disability.ConclusionsVocational rehabilitation after musculoskeletal- and mental-related work disability showed only shorter-term effectiveness on work participation and only among those with longer work disability histories. The effectiveness of alternative and complementary interventions to vocational rehabilitation should be investigated.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Lallukka ◽  
E Kronholm ◽  
J Pekkala ◽  
S Jäppinen ◽  
J Blomgren ◽  
...  

Abstract Background Early exit from paid employment is a notable public health and societal challenge. Previous research has largely focused on the relationships among variables instead of the relationships among individuals with different work participation history. Person-oriented methods enable to identify latent groups of individuals who are likely to follow similar development in their work participation over time. We thus aimed to identify work participation trajectories during early and midlife careers and their social determinants. A further aim was to determine the cumulative incidence of sickness absence due to key diagnostic groups, mental disorders and musculoskeletal diseases within the trajectories. Methods Young (25-38 years at baseline, n = 495663) and midlife (39-52 years at baseline, n = 603085) Finnish people, working in 2004, were followed up through 2013, with registers of the Social Insurance Institution, and the Statistics Finland. The registers provided data for the outcome (work participation) and its determinants and sickness absence. Latent class growth analysis was used to identify trajectories. Results Three distinctive trajectories were identified: temporary exit, permanent exit, and continuously employed people. As compared to the other trajectories, those belonging to the permanent exit trajectory were more likely men, manual workers and had a lower income. The cumulative incidence of sickness absence due to mental disorders was highest in the permanent exit trajectory group. For musculoskeletal diseases, the cumulative incidence of sickness absence increased in the permanent exit trajectory mainly in the older age groups. Conclusions Distinct group-based trajectories of early work exit can be identified in a representative cohort of initially employed people. Focusing on the determinants of premature exit and early intervention to tackle increasing sickness absence may promote work participation particularly in the most vulnerable groups. Key messages Distinct trajectories of premature exit from paid employment can be identified in a nationally representative cohort of initially employed people from Finland. Focusing on the determinants and reasons of premature long-term labor market exit may help promote work participation particularly in the most vulnerable groups.


Author(s):  
Johanna Kausto ◽  
Tuula Oksanen ◽  
Aki Koskinen ◽  
Jaana Pentti ◽  
Pauliina Mattila-Holappa ◽  
...  

AbstractPurpose Employers increasingly use ‘return to work’ (RTW) coordinators to support work ability and extend working careers, particularly among employees with reduced work ability. We examined whether applying this model was associated with changes in employee sickness absence and disability retirements. Methods We used data from the Finnish Public Sector study from 2009 until 2015. Employees where the model was introduced in 2012 constituted the cases (n = 4120, one municipality) and employees where the model was not in use during the follow-up, represented the controls (n = 5600, two municipalities). We analysed risk of disability retirement in 2013–2015 and risk of sickness absence after (2013–2015) vs. before (2009–2011) intervention by case–control status. Results The incidence of disability retirement after the intervention was lower in cases compared to controls both in the total population (hazard ratio HR = 0.49, 95% CI 0.30–0.79) and in the subgroup of participants with reduced work ability (HR = 0.34, 95% CI 0.12–0.99). The risk of sickness absence increased from pre-intervention to post-intervention period both among cases and controls although the relative increase was greater among cases (RRpost- vs. pre-intervention = 1.26, 95% CI 1.14–1.40) than controls (RRpost- vs. pre-intervention = 1.03, 95% CI 0.97–1.08). In the group of employees with reduced work ability, no difference in sickness absence trends between cases and controls was observed. Conclusions These findings suggest that RTW-coordinator model may increase employee sickness absence, but decrease the risk of disability retirement, i.e., permanent exclusion from the labour market.


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