scholarly journals Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024980 ◽  
Author(s):  
Tiia T M Reho ◽  
Salla A Atkins ◽  
Nina Talola ◽  
Markku P T Sumanen ◽  
Mervi Viljamaa ◽  
...  
Keyword(s):  
Primary Care ◽  
Longitudinal Study ◽  
Occupational Health ◽  
Sick Leave ◽  
Diagnostic Codes ◽  
Frequent Attenders ◽  
Frequent Attendance ◽  
Increased Risk ◽  
Working Age

ObjectivesFrequent attenders (FAs) create a substantial portion of primary care workload but little is known about FAs’ sickness absences. The aim of the study is to investigate how occasional and persistent frequent attendance is associated with sickness absences among the working population in occupational health (OH) primary care.Setting and participantsThis is a longitudinal study using medical record data (2014–2016) from an OH care provider in Finland. In total, 59 676 patients were included and categorised into occasional and persistent FAs or non-FAs. Sick-leave episodes and their lengths were collected along with associated diagnostic codes. Logistic regression was used to analyse associations between FA status and sick leaves of different lengths (1–3, 4–14 and ≥15 days).ResultsBoth occasional and persistent FA had more and longer duration of sick leave than non-FA through the study years. Persistent FAs had consistently high absence rates. Occasional FAs had elevated absence rates even 2 years after their frequent attendance period. Persistent FAs (OR=11 95% CI 7.54 to 16.06 in 2016) and occasional FAs (OR=2.95 95% CI 2.50 to 3.49 in 2016) were associated with long (≥15 days) sickness absence when compared with non-FAs. Both groups of FAs had an increased risk of long-term sick leaves indicating a risk of disability pension.ConclusionBoth occasional and persistent FAs should be identified in primary care units caring for working-age patients. As frequent attendance is associated with long sickness absences and possibly disability pensions, rehabilitation should be directed at this group to prevent work disability.

scholarly journals Comparing occasional and persistent frequent attenders in occupational health primary care – a longitudinal study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Tiia Reho ◽  
Salla Atkins ◽  
Nina Talola ◽  
Markku Sumanen ◽  
Mervi Viljamaa ◽  
...  
Keyword(s):  
Primary Care ◽  
Longitudinal Study ◽  
Occupational Health ◽  
Frequent Attenders

scholarly journals Sociodemographic characteristics and disability pensions of frequent attenders in occupational health primary care – a follow-up study in Finland

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tiia Reho ◽  
Salla Atkins ◽  
Mikko Korhonen ◽  
Anna Siukola ◽  
Markku Sumanen ◽  
...  
Keyword(s):  
Primary Care ◽  
Occupational Health ◽  
Medical Record ◽  
Work Disability ◽  
Service Use ◽  
Sociodemographic Factors ◽  
Medical Record Data ◽  
Frequent Attenders ◽  
Frequent Attendance ◽  
Record Data

Abstract Background Work disability is a complex issue that requires preventive efforts from healthcare systems and individuals, and that too often results in disability pensions (DP). While many studies have attempted to characterize risk factors of work disability, many showing for example a link between socioeconomic positions, working conditions and frequent attendance to OH primary care it is not known if frequent attendance is associated with DP despite the sociodemographic factors. This study aims to address this gap and examine the association between frequent attendance to OH primary care and DP, when adjusted by sociodemographic factors. Methods This study combines routine medical record data of an occupational health service provider with comprehensive national registers. Medical record data were used to define groups of frequent attenders to OH primary care (FA) (1-year-FA, 2-year-FA, persistent-FA and non-FA) from 2014 to 2016. The sociodemographic factors (including i.e. educational level, occupational class, unemployment periods) were derived from Statistic Finland and DP decisions were derived from Finnish Centre for Pensions. Association of frequent attendance to OH primary care with DP decisions were analyzed and adjusted by sociodemographic factors. Results In total, 66,381 patients were included. Basic and intermediate education along with manual and lower non-manual work predicted frequent attendance to OH primary care. Unemployment in 2013 did not predict frequent attendance to OH primary care. Frequent attendance to OH primary care was associated with DP within next two years, even when adjusted for sociodemographic factors. The association of frequent attendance to OH primary care with DP grew stronger as high service use persisted over time. Conclusions Frequent attendance to OH primary care is associated with DP risk in the near future despite the underlying sociodemographic differences. Patients using OH primary care services extensively should be identified and rehabilitative needs and measures necessary to continue in the work force should be explored. Sociodemographic issues that co-exist should be explored and considered when planning interventions.

scholarly journals Frequent attenders in occupational health primary care: A cross-sectional study

2018 ◽  
Vol 47 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Tiia T.M. Reho ◽  
Salla A. Atkins ◽  
Nina Talola ◽  
Mervi Viljamaa ◽  
Markku P.T. Sumanen ◽  
...  
Keyword(s):  
Primary Care ◽  
Occupational Health ◽  
Musculoskeletal System ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Frequent Attenders ◽  
Frequent Attendance ◽  
Mental And Behavioral Disorders

Aims: This study characterizes frequent attenders in primary care provided by occupational health services (OHS) in Finland. Methods: This is a nationwide cross-sectional study using medical record data from an OHS provider in 2015. Frequent attenders were defined as persons who were within the top decile of annual visits to healthcare professionals (frequent attender 10%, FA10) at any of the OHS’s 37 stations. FA10s within this study consulted the OHS primary care unit eight or more times during 2015. We used logistic regression to analyse factors associated with frequent attendance in OHS primary care. The independent variables were age, gender, employer size and industry, health professionals visited and diagnoses given during visits to the OHS. The dependent variable was belonging to the FA10 group. Results: Altogether 31,960 patients met the inclusion criteria and were included in the study. The FA10 group included 3617 patients, who conducted 36% of visits to healthcare professionals. The findings indicate that working within the manufacturing industry, health and social services, or public administration, and being employed in medium or large companies, are associated with frequent attendance. Frequent attendance was also associated with being female, diagnoses of the musculoskeletal system, or mental and behavioral disorders. In particular, depressive episodes and anxiety were associated with FA10s. Conclusions:This research characterized FA10 clients at a Finnish OHS. Illnesses of the musculoskeletal system and mental and behavioral disorders were accentuated among FA10s. The stability of the FA10 group, along with their sickness absences and work disabilities, should be investigated further.

scholarly journals Influence of lifestyle risk factors on work ability and sick leave in a general working population in Norway: a 5-year longitudinal study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045678
Author(s):  
Marit Müller De Bortoli ◽  
Inger M. Oellingrath ◽  
Anne Kristin Moeller Fell ◽  
Alex Burdorf ◽  
Suzan J. W. Robroek
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
Sick Leave ◽  
Work Ability ◽  
Working Population ◽  
Short Term ◽  
Lifestyle Risk Factors ◽  
Lifestyle Risk

ObjectivesThe aim of this study is to assess (1) whether lifestyle risk factors are related to work ability and sick leave in a general working population over time, and (2) these associations within specific disease groups (ie, respiratory diseases, cardiovascular disease and diabetes, and mental illness).SettingTelemark county, in the south-eastern part of Norway.DesignLongitudinal study with 5 years follow-up.ParticipantsThe Telemark study is a longitudinal study of the general working population in Telemark county, Norway, aged 16 to 50 years at baseline in 2013 (n=7952) and after 5-year follow-up.Outcome measureSelf-reported information on work ability (moderate and poor) and sick leave (short-term and long-term) was assessed at baseline, and during a 5-year follow-up.ResultsObesity (OR=1.64, 95% CI: 1.32 to 2.05) and smoking (OR=1.62, 95% CI: 1.35 to 1.96) were associated with long-term sick leave and, less strongly, with short-term sick leave. An unhealthy diet (OR=1.57, 95% CI: 1.01 to 2.43), and smoking (OR=1.67, 95% CI: 1.24 to 2.25) were associated with poor work ability and, to a smaller extent, with moderate work ability. A higher lifestyle risk score was associated with both sick leave and reduced work ability. Only few associations were found between unhealthy lifestyle factors and sick leave or reduced work ability within disease groups.ConclusionLifestyle risk factors were associated with sick leave and reduced work ability. To evaluate these associations further, studies assessing the effect of lifestyle interventions on sick leave and work ability are needed.

scholarly journals Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression: two subgroup analyses

2017 ◽  
Vol 75 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Viktor Kaldo ◽  
Andreas Lundin ◽  
Mats Hallgren ◽  
Martin Kraepelien ◽  
Catharina Strid ◽  
...  
Keyword(s):  
Primary Care ◽  
Physical Exercise ◽  
Sick Leave ◽  
Work Ability ◽  
Response Rate ◽  
Behavioural Therapy ◽  
Total N ◽  
Cognitive Behavioural ◽  
Primary Care Patients

ObjectivesDepression can negatively impact work capacity, but treatment effects on sick leave and employment are unclear. This study evaluates if internet-based cognitive behavioural therapy (ICBT) or physical exercise (PE), with already reported positive effects on clinical outcome and short-term work ability, has better effects on employment, sick leave and long-term work ability compared with treatment as usual (TAU) for depressed primary care patients (German clinical trials: DRKS00008745).MethodsAfter randomisation and exclusion of patients not relevant for work-related analysis, patients were divided into two subgroups: initially unemployed (total n=118) evaluated on employment, and employed (total n=703) evaluated on long-term sick leave. Secondary outcomes were self-rated work ability and average number of sick days per month evaluated for both subgroups. Assessments (self-reports) were made at baseline and follow-up at 3 and 12 months.ResultsFor the initially unemployed subgroup, 52.6% were employed after 1 year (response rate 82%). Both PE (risk ratio (RR)=0.44; 95% CI 0.23 to 0.87) and ICBT (RR=0.37; 95% CI 0.16 to 0.84) showed lower rates compared with TAU after 3 months, but no difference was found after 1 year (PE: RR=0.97; 95% CI 0.69 to 1.57; ICBT: RR=1.23; 95% CI 0.72 to 2.13). For those with initial employment, long-term sick leave (response rate 75%) decreased from 7.8% to 6.5%, but neither PE (RR=1.4; 95% CI 0.52 to 3.74) nor ICBT (RR=0.99; 95% CI 0.39 to 2.46) decreased more than TAU, although a temporary positive effect for PE was found. All groups increased self-rated work ability with no differences found.ConclusionsNo long-term effects were found for the initially unemployed on employment status or for the initially employed on sick leave. New types of interventions need to be explored.

scholarly journals Informal caregiving patterns and trajectories of psychological distress in the UK Household Longitudinal Study

2018 ◽  
Vol 49 (10) ◽  
pp. 1652-1660 ◽  
Author(s):  
Rebecca E. Lacey ◽  
Anne McMunn ◽  
Elizabeth Webb
Keyword(s):  
Psychological Distress ◽  
Longitudinal Study ◽  
Regression Coefficient ◽  
Informal Caregivers ◽  
Informal Caregiving ◽  
Representative Study ◽  
Increased Risk ◽  
The Uk ◽  
Over Time

AbstractBackgroundApproximately seven million people in the UK are engaged in informal caregiving. Informal caregivers are at risk of poorer mental and physical health. However, less is known about how the relationship between the informal caregiving and psychological distress changes over time. The aim of this study was to investigate longitudinal associations between the informal caregiving and psychological distress amongst UK men and women aged 16+.MethodsData were analysed from the UK Household Longitudinal Study (UKHLS, n = 9368), a nationally representative study of UK households. Longitudinal linear mixed modelling was used to estimate associations between the longitudinal patterns of informal caregiving (non-caregiver/one episode of 1–2 years/intermittent caregiving/3+ years caregiving) and trajectories of psychological distress across seven waves of UKHLS data.ResultsInformal caregiving was not associated with psychological distress for men. Women engaged in long-term (⩾3 years) or intermittent caregiving had higher levels of psychological distress at the point of initiation, compared with women who were not caregivers throughout the study period (3+ years caregiver: regression coefficient 0.48, 95% confidence interval (CI) 0.07–0.89; intermittent caregiver: regression coefficient 0.47, 95% CI 0.02–0.92). Trajectories of psychological distress changed little over time, suggesting a plateau effect for these caregiving women.ConclusionsWomen engaged in long-term or repeated shorter episodes of informal caregiving reported more symptoms of psychological distress than non-caregiving women. Given the increased risk of reporting psychological distress and the increasing importance of the informal care sector, the risk of poorer mental health of informal caregivers should be a priority for public health.

Psychological Sequelae of Medical Complications During Pregnancy

PEDIATRICS ◽  
1993 ◽  
Vol 91 (3) ◽  
pp. 566-571
Author(s):  
JoAnne Burger ◽  
Sarah McCue Horwitz ◽  
Brian W.C. Forsyth ◽  
John M. Leventhal ◽  
Philip J. Leaf
Keyword(s):  
Primary Care ◽  
Relative Risk ◽  
Postpartum Depression ◽  
Confidence Interval ◽  
Pregnancy Complications ◽  
Medical Complications ◽  
Community Based ◽  
Increased Risk ◽  
Interview Survey

To determine whether mothers with complicated pregnancies are at increased risk of postpartum depression and whether their children are at increased risk of being perceived as vulnerable, the investigators conducted an interview survey of mothers of 1095 children aged 4 to 8 in a community-based sample of primary care pediatric practices. The offspring were viewed as vulnerable by 17% of the women with severe pregnancy complications and 9% of the women without pregnancy complications (relative risk = 1.88; 95% confidence interval = 1.11, 2.63). Women with a severe complication of pregnancy were significantly more likely to report postpartum depression than those without a complication (27% vs 11%; relative risk = 2.45; 95% confidence interval = 1.55, 3.01). These relationships persisted after adjustment for prematurity, neonatal hospitalization, and demographic factors. It is concluded that pregnancy complications may place a woman at increased risk of postpartum depression and may have important effects on a mother's long-term perceptions of her child's vulnerability to illness.

scholarly journals Frequent short sickness absence, occupational health service utilisation and long-term sickness absence due to mental disorders among young employees

2021 ◽  
Author(s):  
Jaakko Harkko ◽  
Hilla Nordquist ◽  
Olli Pietiläinen ◽  
Kustaa Piha ◽  
Minna Mänty ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Health Service ◽  
Occupational Health ◽  
Sickness Absence ◽  
Cox Regression ◽  
Occupational Health Service ◽  
Linkage Data ◽  
Service Utilisation

Abstract Objectives We examined whether frequent short-term sickness absence (FSTSA) and primary care use in occupational health service (OHS) were associated with medically-certified long-term sickness absence (LTSA) due to mental disorders among young employees. Methods We used record-linkage data covering the young employees (< 35 years) of the City of Helsinki, Finland (n = 8,282) from 2010 to 2014. The outcome was LTSA due to mental disorders. Cox regression models were fitted. Results FSTSAs were associated with subsequent LTSA. Also OHS use predicted LTSA due to mental disorders; however, this association was not found for those with prior FSTSA. Conclusions Both FSTSA and primary care use indicate subsequent LTSA independently, and together these indicators identify a larger proportion of individuals at risk of LTSA due to mental disorders.

scholarly journals Frequent attenders at risk of disability pension: a longitudinal study combining routine and register data

2019 ◽  
Vol 48 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Tiia T.M. Reho ◽  
Salla A. Atkins ◽  
Nina Talola ◽  
Markku P.T. Sumanen ◽  
Mervi Viljamaa ◽  
...  
Keyword(s):  
Disability Pension ◽  
Healthcare Services ◽  
Chronic Illnesses ◽  
The Other ◽  
Study Group ◽  
Frequent Attenders ◽  
Frequent Attendance ◽  
Increased Risk ◽  
Occupational Healthcare

Aims: Frequent attendance in healthcare services is associated with ill-health and chronic illnesses. More information is needed about the phenomenon’s connection with disability pensions (DPs). Methods: The study group comprised 59,676 patients divided into occasional- (1yFAs) and persistent frequent attenders (pFAs) and non-frequent attenders (non-FAs). Odds ratios for DP were analysed for these groups taking into account preceding sickness absence days. The awarded DPs were obtained from the Finnish Centre for Pensions and data on primary care visits were obtained from Pihlajalinna, a nationwide occupational healthcare provider. Results: 1yFAs and pFAs have more DPs than non-FAs. During follow-up, 14.9% of pFAs, 9.6% of 1yFAs and 1.6% of non-FAs had a DP decision of any kind. pFAs receive more partial and fixed-term decisions than the other groups and most permanent DPs are granted to 1yFAs. Musculoskeletal disorders are the most common reason for illness-based retirement in all groups but 1yFAs and pFAs have proportionally more mental disorders leading to DP. The group of non-FAs, on the other hand, has more DPs granted based on neoplasms. Both 1yFAs and pFAs have an increased risk of DP but the effect is diluted after taking into account preceding sick-leave. Conclusions: Frequent attendance of healthcare services, both occasional and persistent, is associated with increased risk of future DP. The association is linked to increased sickness absences. Frequent attenders should be identified and their rehabilitative needs evaluated. Frequency of consultation could be used in selecting candidates for early rehabilitation before sickness absences develop.

Sign in / Sign up

Export Citation Format

Share Document