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Josephson, Malin
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Publications (10 of 32) Show all publications
Leijon, O., Josephson, M. & Osterlund, N. (2015). How common is change of primary diagnosis during an episode of sickness benefit?: A register study of medical sickness certificates issued 2010-2012 in Sweden. Scandinavian Journal of Public Health, 43(1), 44-51
Open this publication in new window or tab >>How common is change of primary diagnosis during an episode of sickness benefit?: A register study of medical sickness certificates issued 2010-2012 in Sweden
2015 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 1, p. 44-51Article in journal (Refereed) Published
Abstract [en]

Aim: The aims of this study were to investigate how common it is to change primary diagnosis between different diagnostic chapters during a sick-leave spell, and to explore patterns of diagnostic changes. Methods: The unit for analysis was episode of sickness benefit, that is, sick leave >14 days, which commenced between 2010 and 2012 in Sweden. For each case, the primary diagnosis was retrieved from the first and last/latest medical sickness certificate, respectively. The number of days of sickness benefit was linked to the cases. Any change of primary diagnosis was analysed by diagnostic chapter according to the ICD-10, and this was done separately for women and men. Results: In total, 803,041 cases of sickness benefit (63% women) were included in the study. During a sick-leave spell, 7.1% of female cases and 6.6% of male cases changed their primary diagnosis to a diagnosis from another diagnostic chapter. The change of primary diagnosis increased with the number of days with sickness benefit. For female cases, this increase was from 2.0% for cases that lasted 15-30 days to 20.2% for cases that lasted >365 days. For male cases, the corresponding increase was from 1.8% to 21.2%. A change of primary diagnosis was least common among those initially sick-listed for mental disorders and musculoskeletal disorders. The patterns of diagnostic changes were rather similar for women and men. Conclusions: A change of diagnosis during a sick-leave spell needs to be taken into consideration by the sickness insurance system and in the actions taken by its administration. Registry-based studies of sickness insurance need to consider diagnostic changes in both the study design and the interpretation of results.

Keywords
Sickness certification, sick-listing, ICD-10, diagnostic chapter, sick leave, sickness absence, social insurance medicine, gender, register study, Sweden
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-243655 (URN)10.1177/1403494814560843 (DOI)000347444800007 ()25425228 (PubMedID)
Available from: 2015-02-25 Created: 2015-02-11 Last updated: 2018-01-11Bibliographically approved
Hallberg, D., Johansson, P. & Josephson, M. (2015). Is an early retirement offer good for your health?: Quasi-experimental evidence from the army. Journal of Health Economics, 44, 274-285
Open this publication in new window or tab >>Is an early retirement offer good for your health?: Quasi-experimental evidence from the army
2015 (English)In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 44, p. 274-285Article in journal (Refereed) Published
Abstract [en]

This paper studies empirically the consequences on health of an early retirement offer. To this end we use a targeted retirement offer to military officers 55 years of age or older. Before the offer was implemented, the normal retirement age in the Swedish defense was 60 years of age. Estimating the effect of the offer on individuals' health within the age range 56-70, we find support for a reduction in both mortality and in inpatient care as a consequence of the early retirement offer. Increasing the mandatory retirement age may thus not only have positive government income effects but also negative effects on increasing government health care expenditures.

Keywords
Health, Mortality, Inpatient care, Retirement, Pensions
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-275481 (URN)10.1016/j.jhealeco.2015.09.006 (DOI)000367408200019 ()26547865 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2016-02-04 Created: 2016-02-04 Last updated: 2018-01-10Bibliographically approved
Hallberg, D., Johansson, P. & Josephson, M. (2015). Is an early retirement offer good for your health?: Quasi-experimental evidence from the army. Journal of Health Economics, 44, 274-285
Open this publication in new window or tab >>Is an early retirement offer good for your health?: Quasi-experimental evidence from the army
2015 (English)In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 44, p. 274-285Article in journal (Refereed) Published
National Category
Probability Theory and Statistics
Identifiers
urn:nbn:se:uu:diva-287917 (URN)10.1016/j.jhealeco.2015.09.006 (DOI)
Available from: 2016-04-27 Created: 2016-04-26 Last updated: 2019-04-29Bibliographically approved
Leijon, O., Josephson, M. & Osterlund, N. (2015). Sick-listing adherence: a register study of 1.4 million episodes of sickness benefit 2010-2013 in Sweden. BMC Public Health, 15, Article ID 380.
Open this publication in new window or tab >>Sick-listing adherence: a register study of 1.4 million episodes of sickness benefit 2010-2013 in Sweden
2015 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 380Article in journal (Refereed) Published
Abstract [en]

Background: This register study aims to increase the knowledge on how common it is that sickness benefit recipients are sick-listed for as long as their physician prescribes in their medical sickness certificate, i.e. sick-listing adherence, or wholly/partly bring return-to-work (RTW) forward, i.e. early RTW. Methods: The unit for analysis was an episode of 100% sickness benefit, commenced between 1 January 2010 and 31 December 2013. Completed episodes of sickness benefit and full or partial early RTW was analysed by comparing the prescribed length of sick leave in medical sickness certificates and benefit days disbursed by the sickness insurance system. Probability for a full and partial early RTW was estimated with hazard ratio (HR) using the Cox proportional hazard model. Results: In total, about 1.4 million episodes of sickness benefit (60% women) were included in the study. The overall sick-listing adherence was 84% for women and 82% for men during the first year of sick leave. Adherence varied between 82 and 87% among women and between 79 and 86% among men with regard to ICD-10 diagnosis chapter. The probability of an early RTW varied between diagnosis chapters, where mental disorders was associated with a lower probability of a full early RTW among women and men (HR 0.52 and HR 0.47) as well as a partial early RTW (HR 0.51 and HR 0.46). Younger age (16-29 years), high educational level and high income was associated with a higher probability of an early RTW, while older age (>= 50 years), not native-born, low educational level, unemployment and parental leave were associated with a lower probability. Conclusion: The study demonstrates that sick-listing adherence is relatively high. Probability of an early RTW differs with regard to diagnosis chapter, demographic, socioeconomic and labour market characteristics of the sickness benefit recipients. Interventions intended to improve the sick-listing process, and to affect the length and degree of sick leave in certain target groups, should include measures targeted at physicians' sick-listing practices. Policies and economic incentives aimed at promoting RTW need to focus on individuals' residual capacity for work.

Keywords
Sickness certification, Sick-listing, Adherence, Compliance, Sickness benefit, Return-to-work, Social insurance medicine, Gender, Register study, Sweden
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-252685 (URN)10.1186/s12889-015-1741-2 (DOI)000352851800001 ()25887477 (PubMedID)
Available from: 2015-05-26 Created: 2015-05-11 Last updated: 2018-01-11Bibliographically approved
Leijon, O., Lindahl, E., Toren, K., Vingård, E. & Josephson, M. (2014). First-time decisions regarding work injury annuity due to occupational disease: a gender perspective. Occupational and Environmental Medicine, 71(2), 147-153
Open this publication in new window or tab >>First-time decisions regarding work injury annuity due to occupational disease: a gender perspective
Show others...
2014 (English)In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 71, no 2, p. 147-153Article in journal (Refereed) Published
Abstract [en]

Objectives This study presents an investigation of first-time decisions regarding work injury annuity due to occupational disease. Focus is a number of potential underlying factors behind the gender gap, where women are disadvantaged, in the granting of work injury annuity. Methods All 99 subjects (80 men and 19 women) who met the conditions of long-lasting reduction of work ability due to occupational disease (not occupational accident) in the Swedish Work Injury Insurance Act and were granted work injury annuity in 2010, together with a random sample of 118 subjects (55 men and 63 women) who were denied annuity in the same year, were selected for analysis. Each subject's case file from the Social Insurance Agency was examined with regards to cause of disease, diagnosis and the Social Insurance Agency's management and decision making of claims. The data were analysed by logistic regression analysis. Results Men had a higher probability of being granted work injury annuity than women for musculoskeletal disorders (OR 4.16), mental disorders (OR 7.93) and diseases in other diagnostic chapters (OR 3.65). After adjustment for age, country of birth, diagnosis, work exposure factors and decision support factors, the higher probability for men of being granted work injury annuity remained (full model: OR 2.67, 95% Cl 1.20 to 5.94). Conclusions Actions are necessary in order to establish equitable and gender-neutral treatment of work injury insurance claims. There is a need for more detailed knowledge of exposures in female-dominated jobs and the relationship between these exposures and occupational disease.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-219193 (URN)10.1136/oemed-2013-101489 (DOI)000330108100013 ()
Available from: 2014-02-25 Created: 2014-02-24 Last updated: 2017-12-05Bibliographically approved
Arsalani, N., Fallahi-Khoshknab, M., Josephson, M. & Lagerstrom, M. (2014). Musculoskeletal Disorders and Working Conditions Among Iranian Nursing Personnel. International Journal of Occupational Safety and Ergonomics, 20(4), 671-680
Open this publication in new window or tab >>Musculoskeletal Disorders and Working Conditions Among Iranian Nursing Personnel
2014 (English)In: International Journal of Occupational Safety and Ergonomics, ISSN 1080-3548, E-ISSN 2376-9130, Vol. 20, no 4, p. 671-680Article in journal (Refereed) Published
Abstract [en]

This study investigated the prevalence of musculoskeletal disorders (MSDs) and associations with organizational, physical and psychosocial working conditions among 520 nursing personnel in Tehran, Iran. The results of the cross-sectional study on aids and different educational levels of nurses showed that the participants experienced 88% of MSDs in at least one body region during the past 12 months. The 3 most prevalent body regions were the low back (65.3%), knee (56.2%) and neck (49.8%). The participants reported inflexible work schedule, poor quality of devices for transferring patients, overexertion and job dissatisfaction. Physical and psychosocial exposure revealed an elevated odds ratio (95% confidence interval) of MSDs. The results showed a combination of high physical and psychosocial work demands along with low control over the work which increased work-related stress and enhanced the risk of MSDs. This study findings could help to understand work-related MSDs among nursing personnel in a developing country where the work situation and sociocultural context differ from other countries.

Keywords
musculoskeletal disorders, physical working conditions, psychosocial working conditions, nurse, Iran
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-243703 (URN)000347510900013 ()25513802 (PubMedID)
Available from: 2015-02-11 Created: 2015-02-11 Last updated: 2018-01-11Bibliographically approved
Gunnarsson, K., Larsson, M., Schill, H. P. & Josephson, M. (2014). Return to work in small enterprises. Small Enterprise Research: The Journal of SEAANZ, 21(2), 229-237
Open this publication in new window or tab >>Return to work in small enterprises
2014 (English)In: Small Enterprise Research: The Journal of SEAANZ, ISSN 1321-5906, Vol. 21, no 2, p. 229-237Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to understand and identify possible areas of improvement for the return-to-work process in small enterprises. The study used a qualitative approach. Semi-structured interviews were conducted with 16 small enterprises in Sweden. The employers in the enterprise have made efforts to adapt the workplace for employees on sick leave. However, there was no set procedure for handling contacts between the employer and employee during periods of sick leave and employers indicated that they were unsure how to cooperate with the Swedish Social Insurance Agency in the return-to-work process. An area for improvement is extended professional competence and support in the return-to-work process in order to identify possibilities to enable adaption of the workplace and facilitate return to work. The occupational health service have or should have the knowledge required and could play an active role in improvement of the return-to-work process. 

Keywords
return to work, small enterprises, social insurance, occupational health service
National Category
Medical and Health Sciences
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:uu:diva-239266 (URN)10.1080/13215906.2014.11082091 (DOI)
Available from: 2014-12-20 Created: 2014-12-20 Last updated: 2017-12-05Bibliographically approved
Vaez, M., Josephson, M., Vingård, E. & Voss, M. (2014). Work-related violence and its association with self-rated general health among public sector employees in Sweden. Work: A journal of Prevention, Assesment and rehabilitation, 49(1), 163-171
Open this publication in new window or tab >>Work-related violence and its association with self-rated general health among public sector employees in Sweden
2014 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 49, no 1, p. 163-171Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Work-related violence is one of the most serious threats to employee safety and health.

OBJECTIVE:

To ascertain the extent of self-reported violence or threats of violence at work in relation to the general health of public sector employees.

METHODS:

The study population comprised 9,611 female (83%) and male public employees in Sweden. A questionnaire based on items derived mainly from validated instruments was constructed to cover aspects such as health, lifestyle, and physical and psychosocial work conditions.

RESULTS:

One in three employees reported work-related violence, with the highest proportions among psychiatric nurses (79%) and psychiatric attendants (75%). Work-related violence more often affected those who were < 45 years old, worked < 40 hours/week, worked nights, or reported poor health. Regardless of gender, age, hours of work, night work, and type of occupation, exposure to work-related violence was associated with less than good general health, and this relationship was strongest for psychiatric nurses (OR=3.19; 95% CI=1.28-7.98), medical doctors/dentists (OR=2.46; 95% CI=1.35-4.49), compulsory school teachers (OR=2.14; 95% CI=1.33-3.45), and other nurses (OR=1.87; 95% CI=1.23-2.84).

CONCLUSIONS:

Work-related violence was frequently reported by employees in the most common public sector occupations, and it was associated withpoor health in both genders.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-208593 (URN)10.3233/WOR-131715 (DOI)000342237600017 ()24004771 (PubMedID)
Available from: 2013-10-04 Created: 2013-10-04 Last updated: 2018-01-11Bibliographically approved
Heijbel, B., Josephson, M. & Vingård, E. (2013). Implementation of a rehabilitation model for employees on long-term sick leave in the public sector: Difficulties, counter-measures, and outcomes. Work: A journal of Prevention, Assesment and rehabilitation, 45(3), 323-333
Open this publication in new window or tab >>Implementation of a rehabilitation model for employees on long-term sick leave in the public sector: Difficulties, counter-measures, and outcomes
2013 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 45, no 3, p. 323-333Article in journal (Refereed) Published
Abstract [en]

Objective:

The aim was threefold: 1) to describe the experiences of driving and implementing a workplace-based rehabilitation intervention in cooperation with the occupational health service (OHS); 2) to investigate which people received multimodal and/or vocational rehabilitation measures; 3) to find predictors of return to work (RTW).

Participants:

Altogether 779 employees on sick leave for 90 days or more with mainly musculoskeletal or psychological/stress-related problems, 90% women.

Methods:

The HAKuL model was introduced, implying an early team assessment at the OHS and good access to rehabilitation measures. The study is a prospective three-year study with a two-year follow-up.

Results:

The rehabilitation intervention encountered challenges. Counter-measures were taken to facilitate coordination and communication. People with musculoskeletal problems often received both multimodal and vocational rehabilitation. Vocational rehabilitation was advocated for people who were under 55 years of age, and for those with stress-related problems. The strongest predictive factors for RTW were: having received only vocational rehabilitation and being under 45 years of age.

Conclusion:

The HAKuL model can be used in a wider context, but the study shows the need for coordination between multiple stakeholders. Supervisors should pay attention to people who have musculoskeletal problems and are older, as soon as problems emerge.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-190073 (URN)10.3233/WOR-2012-1478 (DOI)000323484000006 ()22976164 (PubMedID)
Available from: 2013-01-07 Created: 2013-01-07 Last updated: 2017-12-06Bibliographically approved
Kjellberg, K., Palm, P. & Josephson, M. (2012). Development of an instrument for assessing workstyle in checkout cashier work (BAsIK). Work: A journal of Prevention, Assesment and rehabilitation, 41(Suppl 1), 663-668
Open this publication in new window or tab >>Development of an instrument for assessing workstyle in checkout cashier work (BAsIK)
2012 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, no Suppl 1, p. 663-668Article in journal (Refereed) Published
Abstract [en]

Checkout cashier work consists of handling a large number of items during a work shift, which implies repetitive movements of the shoulders, arms and hands/wrists, and a high work rate. The work is associated with a high prevalence of disorders in the neck and upper extremity. The concept of workstyle explains how ergonomic and psychosocial factors interact in the development of work-related upper extremity disorders. The aim of the project was to develop an instrument for the occupational health services to be used in the efforts to prevent upper extremity disorders in checkout cashier work. The instrument is based on the workstyle concept and is intended to be used as a tool to identify high-risk workstyle and needs for interventions, such as training and education. The instrument, BAsIK, consists of four parts; a questionnaire about workstyle, an observation protocol for work technique, a checklist about the design of the checkout and a questionnaire about work organization. The instrument was developed by selecting workstyle items developed for office work and adapting them to checkout cashier work, discussions with researchers and ergonomists, focus-group interviews with cashiers, observations of video recordings of cashiers, and studies of existing guidelines and checklists.

Keywords
participative ergonomics, psychosocial factors, upper extremity disorders, workplace design, organization
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-181957 (URN)10.3233/WOR-2012-0223-663 (DOI)000306361800109 ()
Available from: 2012-10-02 Created: 2012-10-02 Last updated: 2017-12-07Bibliographically approved
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