Seurantatutkimus erikoissairaanhoidon kuntoutustutkimuspotilaiden työmarkkinatilanteesta, elämänlaadusta sekä koetusta työ- ja toimintakyvystä

Työurien pidentämisessä ja työhön osallistumisen lisäämisessä oleellista on tukea myös osatyökykyisten henkilöiden työhön kiinnittymistä ja työssä jatkamista. Tutkimuksen tavoitteena oli selvittää erikoissairaanhoidon kuntoutustutkimuspotilaiden (N = 238) työmarkkinatilanteen, sairausetuuksien käytön, elämänlaadun sekä työ- ja toimintakyvyn muutoksia vuoden kuluttua kuntoutustutkimuksesta. Kuntoutustutkimuksessa olleiden osallistuminen työmarkkinoille sekä ammatilliseen kuntoutukseen lisääntyi ja samalla sairausetuuksien käyttö väheni. Potilaiden elämänlaatu, koettu terveys ja työkyky sekä itsestä huolehtiminen paranivat. Vastaavasti kognitiivinen ja fyysinen toimintakyky sekä osallisuus heikkenivät. Systemaattisella ja moniammatillisella työ- ja toimintakyvyn arvioinnilla voidaan saavuttaa vaikuttavia suunnitelmia työllistymisen edistämiseksi. Abstract Follow-up study on the labor market situation, quality of life and perceived work ability and functioning of patients of a rehabilitation outpatient clinicIn order to prolong working careers and increase participation in work, it is also important to support the attachment and continuation of people with partial ability to work. The aim of the study was to find out the changes in the labor market situation, the use of sick leave, quality of life, and work ability and functioning of the outpatient clinic of the Department of Physical Medicine and Rehabilitation (N=238) during one-year follow-up. Participation in the labor market and vocational rehabilitation of those who participated in rehabilitation increased, and at the same time the use of sickness benefits decreased. Patients’ quality of life, perceived health and work ability, and self-care improved. Correspondingly, cognitive and physical functioning as well as inclusion were impaired. Systematic and multi-professional assessment of work ability and functioning can lead to effective plans to promote employment. Keywords: rehabilitation, employment status, quality of life, work ability, functioning

Work Accident and Sickness Benefits

This entry traces past and present trends in the institutional development of income transfers in the case of work accident and sickness. The focus is mainly on OECD or European countries, but in some instances, references are made to a wider array of countries or continents. The entry begins with a review of the history of work accident insurance; in most countries, this was the first social insurance programme to be created. The history of this early programme highlights a number of factors behind the development of later programmes. The latter part of the entry focuses on sickness insurance. Again, we begin with historical developments, focusing in particular on the universalism and generosity of benefits. We then move on to discuss the extent to which sickness benefits have, in recent years, been targets for retrenchment. The final section tentatively discusses future trajectories of these two income maintenance programmes.

Sickness absence during the COVID-19 pandemic

The aim of this research was to perform comparative analysis of the publicly avaiable data of the Social Insurance Institution (ZUS) on sickness absence of insured persons in Poland in 2016-2021 (before the outbreak and during the COVID-19 pandemic). Materials and methods. The research material consisted of data from the Social Insurance Institution for the years 2016-2021 (Q1) concerning the sickness absence of the insured. Due to the publication of data in an aggregated form, quantitative analysis was performed instead of statistical analysis. The data used in the analysis included the number of insured persons, the number of people receiving sickness benefits, the number of issued medical certificates on temporary incapacity to work and the reasons for the incapacity to work. Results and Conclusion. Since the beginning of the COVID-19 pandemic, following numbers have increased compared to 2019: the number of people receiving sickness benefit in Poland (by 10%), the number of days of sickness absence (by 7%) and the number of issued medical certificates of temporary incapacity for work (by 4%). The largest increase in the number of beneficiaries, the number of days of sickness absence and the number of medical certificates was recorded in the Q4 of 2020 (respectively by 21%, 16% and 24% compared to Q4 of 2019). Due to COVID-19, 4.84 million days of sickness absence were used in 2020 – it was the tenth cause of absence. The largest changes in the number of people receiving sickness benefit and the number of days of sickness absence can be observed in Q1 and Q4, which may result from the seasonality of COVID-19 and the subsequent wave of infections. Importantly, COVID-19 is not the only factor contributing overall increase in the number of days of sickness absence in Poland – absence due to non-communicable diseases also increased during the pandemic.

Social validity of work ability evaluations and official decisions within the sickness insurance system: A client perspective

BACKGROUND: Studies of the social validity of work ability evaluations are rare, although the concept can provide valuable information about the acceptability, comprehensibility and importance of procedures. OBJECTIVE: The aim of this study was to explore clients’ perceptions of social validity of work ability evaluations and the following official decisions concerning sickness benefits within the Swedish sickness insurance system. METHODS: This was a longitudinal qualitative study based on interviews with 30 clients on sick leave, analyzed through deductive content analysis. RESULTS: Clients’ understanding of the evaluation was dependent on whether the specific tests were perceived as clearly related to the clients’ situation and what information they received. For a fair description of their work ability, clients state that the strict structure in the evaluation is not relevant to everyone. CONCLUSION: The work ability evaluations indicate low acceptability due to lack of individual adaptation, the comprehensibility varied depending on the applicability of the evaluation and information provided, while the dimension ‘importance’ indicated as higher degree of social validity. The official decision about sickness benefits however was considered unrelated to the evaluation results, lacking solid arguments and sometimes contradictory to other stakeholders’ recommendations indicating poor social validity.

Skipping the doctor: evidence from a case with extended self-certification of paid sick leave

This paper examines the impact of a policy reform in a municipality in Norway that extended to workers the right to self-certify sickness absence from work. After the reform, workers were no longer obliged to obtain a certificate from a physician to receive sickness benefits. They could call in sick directly to their line leader and had to engage in a counselling program organized by the employer. To estimate the effect of this reform, we contrast the change in sickness absence among employees who were granted the extended right to self-certify absence with absence among employees who had to obtain a physician’s certificate to be entitled to sickness benefits. We use both a standard difference-in-differences method and the synthetic control method to estimate the effect of the reform. We can rule out large positive effects on absence after the reform, with strong evidence that the policy change actually resulted in a reduction in absence for female workers.

Use of Sickness Benefits by Patients With Metastatic Breast Cancer – A Swedish Cohort Study

Background Advances in the treatment of metastatic breast cancer (mBC) have led to improved life expectancy. Many cancer survivors desire to return to paid work to enhance their sense of well-being. For patients with mBC, little is known about how the diagnosis impacts ability to work or the factors that increase the need for sickness benefits. Patients and methods Data were collected from two Swedish national registers, for females ages 18 to 63 years in the Stockholm-Gotland healthcare region with a new diagnosis of mBC from 1997 through 2011. Type of first-line palliative treatment was identified in medical records of a subset of the study population. Use of sickness absence (SA) and disability pension (DP) by these patients during the year before and one and two years after mBC diagnosis was determined from a third register. Regression analysis was performed to ascertain which covariate factors were associated with long-term (> 30 days) SA. Results A total of 1,240 patients were evaluated the year before and the first year after mBC diagnosis; only 805 patients were still alive and evaluated the second year after diagnosis. The proportions of patients having SA and DP were 56.0% and 24.8% the year before, 69.9% and 28.9% the first year after, and 64.0% and 34.7% the second year after diagnosis, respectively. Adjusted odds of having long-term SA were significantly higher at 1 and 2 years after diagnosis for patients with age < 45 years (AOR = 3.43 and AOR = 1.70, respectively), early calendar year of diagnosis (AOR = 1.72 and AOR = 1.79, respectively), metachronous mBC (AOR = 4.85 and AOR = 4.52, respectively), and SA ≥ 90 days the year before diagnosis (AOR = 3.44 and AOR = 1.98, respectively). Odds were also significantly higher the second after diagnosis for patients treated with chemotherapy (AOR = 1.81) or radiotherapy (AOR = 2.23), compared to those treated with hormonal therapy, Conclusions Rates of SA and DP increase after a diagnosis of mBC. Women who are younger, develop metachronous mBC, use SA heavily before mBC, and receive chemotherapy or radiotherapy have a greater need for sickness benefits after an mBC diagnosis.

Patterns and predictors of sick leave after Covid-19 and long Covid in a national Swedish cohort

Background The impact of Covid-19 and its long-term consequences is not yet fully understood. Sick leave can be seen as an indicator of health in a working age population, and the present study aimed to investigate sick-leave patterns after Covid-19, and potential factors predicting longer sick leave in hospitalised and non-hospitalised people with Covid-19. Methods The present study is a comprehensive national registry-based study in Sweden with a 4-month follow-up. All people who started to receive sickness benefits for Covid-19 during March 1 to August 31, 2020, were included. Predictors of sick leave ≥1 month and long Covid (≥12 weeks) were analysed with logistic regression in the total population and in separate models depending on inpatient care due to Covid-19. Results A total of 11,955 people started sick leave for Covid-19 within the inclusion period. The median sick leave was 35 days, 13.3% were on sick leave for long Covid, and 9.0% remained on sick leave for the whole follow-up period. There were 2960 people who received inpatient care due to Covid-19, which was the strongest predictor of longer sick leave. Sick leave the year prior to Covid-19 and older age also predicted longer sick leave. No clear pattern of socioeconomic factors was noted. Conclusions A substantial number of people are on sick leave due to Covid-19. Sick leave may be protracted, and sick leave for long Covid is quite common. The severity of Covid-19 (needing inpatient care), prior sick leave, and age all seem to predict the likelihood of longer sick leave. However, no socioeconomic factor could clearly predict longer sick leave, indicating the complexity of this condition. The group needing long sick leave after Covid-19 seems to be heterogeneous, indicating a knowledge gap.