How to measure sickness absence? Literature review and suggestion of five basic measures

Unit of Social Medicine, University of Gothenburg, Goeteborg, Västra Götaland, Sweden
Scandinavian journal of social medicine 07/1998; 26(2):133-44. DOI: 10.1177/14034948980260020201
Source: PubMed

ABSTRACT To examine different sick-leave measures used in sickness absence research, and to suggest a systematic way of assessing sickness absence.
A review and analysis of five major studies on sick-leave performed 1983-1988 with an epidemiological approach.
Terminology and measures used varied in the different studies reviewed. The choice of a certain measure was seldom discussed in relation to the aim of the study. Based on the review five measures are suggested: frequency, length, incidence rate, cumulative incidence and duration. The definition of incidence rate is new and is a measure useful in studies of recurrent events within epidemiology.
We have reviewed sick-leave measures previously used in the literature and suggested five basic measures for assessing sick-leave.

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Available from: Kristina Alexanderson, Apr 27, 2015
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    • "ever , not specifically on patients with depressive disorders . Moreover , sick - ness absence can be measured in many different ways and can vary in terms of duration , full - or part - time , number of sick - leave spells , and sick - leave diagnoses . For that reason , more than one sick - leave measure would be needed to cover its complexity ( Hensing et al . , 1998 ; Borg et al . , 2006 ) . So far , within this area only one study has taken different measures of sickness absence into consideration ( Ishtiak - Ahmed et al . , 2013 ) . That study reported higher risk of suicide attempt and suicide among indivi - duals with a mental disorder , namely those sickness absent due to stress - related ment"
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    ABSTRACT: Studies based on large data sets investigating a wide range of risk indicators on suicidal behavior in patients with depressive disorders are sparse. This study aimed to examine the association of sick-leave measured in different ways on one hand and socio-demographics, medication, and health care on the other hand with suicide attempt and suicide among patients with depressive disorders. This is a population-based prospective cohort study using nationwide register data. All individuals who lived in Sweden 31.12.2004, then aged 16-64 years, and had psychiatric in- or out-patient care due to depressive disorders in 2005 were included (N=21,096). Univariate and multivariate hazard ratios (HR) and 95% Confidence Intervals (CI) with regard to suicide attempt and suicide during 2006-2010 were estimated by Cox regression. Those with new sick-leave spells, full-time spells, spells due to mental diagnoses and exceeding one year and those having ≥1 sick-leave spells had a higher risk of suicide attempt. Female sex, young age, lower education, living alone, prescription of antidepressants and anxiolytics, inpatient health care, and suicide attempts resulted in higher HRs of suicide attempt in the multivariate analyses (range of HRs 1.17-3.28). Male sex, combined antidepressant and anxiolytic prescription, mental inpatient health care, and suicide attempts predicted subsequent suicide (range of HRs 1.84-3.33). Focus on specialized health care limited generalization. Sickness absence, social-demographics, and medical determinants were associated with suicidal behavior. These risk indicators should be considered when monitoring individuals with depressive disorders and assessing suicide risk. Copyright © 2014 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 11/2014; 173C:201-210. DOI:10.1016/j.jad.2014.10.069 · 3.38 Impact Factor
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    • "In this study, sick leave patterns were measured in terms of sickness absence rate and number of sick leave episodes [27]. Individual sickness absence rates were calculated as follows: "
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    ABSTRACT: Background Sickness absence is a growing public health problem in Norway and Denmark, with the highest absence rates being registered in Norway. We compared time trends in sickness absence patterns of municipal employees in the health and care sectors in Norway and Denmark. Methods Data from 2004 to 2008 were extracted from the personnel registers of the municipalities of Kristiansand, Norway, and Aarhus, Denmark, for 3,181 and 8,545 female employees, respectively. Age-specific comparative statistics on sickness absence rates (number of calendar days of sickness absence/possible working days) and number of sick leave episodes were calculated for each year of the study period. Results There was an overall increasing trend in sickness absence rates in Denmark (P = 0.002), where rates were highest in the 20–29- (P = 0.01) and 50–59-year-old age groups (P = 0.03). Sickness absence rates in Norway were stable, except for an increase in the 20–29-year-old age group (P = 0.004). In both Norway and Denmark, the mean number of sick leave episodes increased (P <0.0001 and P <0.0001, respectively) in all age groups except for the 30–39- and 60–67-year-old age groups. The proportion of employees without sickness absence was higher in Norway than in Denmark. Both short-term and long-term absence increased in Denmark (P = 0.003 and P <0.0001, respectively), while in Norway, only short-term absence increased (P = 0.09). Conclusions We found an overall increase in sickness absence rates in Denmark, while the largest overall increase in sick leave episodes was found in Norway. In both countries, the largest increases were observed among young employees. The results indicate that the two countries are converging in regard to sickness absence measured as rates and episodes.
    Human Resources for Health 07/2014; 12(1):37. DOI:10.1186/1478-4491-12-37 · 1.83 Impact Factor
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    • "Apart from the effect of age, inconsistencies in the reported associations between work factors and sick leave are considerable. This was suggested to be due partly to the different measures of sick leave themselves [12,26]. Hence, most studies analyse length of sick leave and frequency of spells separately, and any independent association between length versus frequency and psychosocial work factors therefore remains unknown. "
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    ABSTRACT: It has been suggested that frequent-, short-term sick leave is associated with work environment factors, whereas long-term sick leave is associated mainly with health factors. However, studies of the hypothesis of an association between a poor working environment and frequent short spells of sick leave are few and results are inconsistent. Therefore, we aimed to explore associations between self-reported psychosocial work factors and workplace-registered frequency and length of sick leave in the eldercare sector. Employees from the municipal eldercare in Aarhus (N = 2,534) were included. In 2005, they responded to a work environment questionnaire. Sick leave records from 2005 were dichotomised into total sick leave days (0–14 and above 14 days) and into spell patterns (0–2 short, 3–9 short, and mixed spells and 1–3 long spells). Logistic regression models were used to analyse associations; adjusted for age, gender, occupation, and number of spells or sick leave length. The response rate was 76%; 96% of the respondents were women. Unfavourable mean scores in work pace, demands for hiding emotions, poor quality of leadership and bullying were best indicated by more than 14 sick leave days compared with 0–14 sick leave days. For work pace, the best indicator was a long-term sick leave pattern compared with a non-frequent short-term pattern. A frequent short-term sick leave pattern was a better indicator of emotional demands (1.62; 95% CI: 1.1-2.5) and role conflict (1.50; 95% CI: 1.2-1.9) than a short-term non-frequent pattern. Age (= < 40 / >40 years) statistically significantly modified the association between the 1–3 long-term sick leave spell pattern and commitment to the workplace compared with the 3–9 frequent short-term pattern. Total sick leave length and a long-term sick leave spell pattern were just as good or even better indicators of unfavourable work factor scores than a frequent short-term sick leave pattern. Scores in commitment to the workplace and quality of leadership varied with sick leave pattern and age. Thus, different sick leave measures seem to be associated with different work environment factors. Further studies on these associations may inform interventions to improve occupational health care.
    BMC Public Health 06/2013; 13(1):578. DOI:10.1186/1471-2458-13-578 · 2.26 Impact Factor
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