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Sick leave track record and other potential determinants of a disability pension: A population based study of 8,218 men and women followed for 16 years
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centrum för klinisk forskning i D län (CKFD).
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Economics.
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2009 (English)In: BMC Public Health, ISSN 1471-2458, Vol. 9, 104- p.Article in journal (Refereed) Published
Abstract [en]

Background: A number of previous studies have investigated various  predictors for being granted a disability pension. The aim of this  study was to test the efficacy of sick-leave track record as a   predictor of being granted a disability pension in a large dataset   based on subjects sampled from the general population and followed for  a long time.  Methods: Data from five ongoing population-based Swedish studies was  used, supplemented with data on all compensated sick leave periods,  disability pensions granted, and vital status, obtained from official   registers. The data set included 8,218 men and women followed for 16   years, generated 109,369 person years of observation and 97,160  sickness spells. Various measures of days of sick leave during follow up were used as independent variables and disability pension grant was  used as outcome. Results: There was a strong relationship between individual sickness  spell duration and annual cumulative days of sick leave on the one hand  and being granted a disability pension on the other, among both men and   women, after adjustment for the effects of marital status, education,  household size, smoking habits, geographical area and calendar time   period, a proxy for position in the business cycle. The interval   between sickness spells showed a corresponding inverse relationship. Of   all the variables studied, the number of days of sick leave per year   was the most powerful predictor of a disability pension. For both men  and women 245 annual sick leave days were needed to reach a 50%  probability of transition to disability. The independent variables,  taken together, explained 96% of the variation in disability pension   grantings. Conclusion: The sick-leave track record was the most important  predictor of the probability of being granted a disability pension in  this study, even when the influences of other variables affecting the  outcome were taken into account.

Place, publisher, year, edition, pages
2009. Vol. 9, 104- p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-97611DOI: 10.1186/1471-2458-9-104ISI: 000265928400002PubMedID: 19368715OAI: oai:DiVA.org:uu-97611DiVA: diva2:172623
Available from: 2008-10-16 Created: 2008-10-16 Last updated: 2011-01-17Bibliographically approved
In thesis
1. Disability Pension with Special Reference to Sick Leave Track Record, Health Effects, Health Care Utilisation and Survival: A Population-based Study
Open this publication in new window or tab >>Disability Pension with Special Reference to Sick Leave Track Record, Health Effects, Health Care Utilisation and Survival: A Population-based Study
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background. In Sweden 10 percent (550,000) of the labour force, aged 18 to 65 years are disability pensioners and about four percent are on sick leave. The knowledge of the course from healthy individual to disability pensioner is not well known and was the theme of this thesis.

Objectives, Material and Methods. The aims of the thesis were to follow the study population regarding sickness absence, health care utilisation, quality of life, and survival. Population based data including 14,538 women and men from three cities in Sweden were used, of whom 1,952 were granted a disability pension at baseline or received one during follow up. Register data, including sickness spells, health care utilisation, and mortality data during 30 years of follow up, and questionnaire data including socio-economic and quality of life data were used.

Results. The most powerful determinant for being granted a disability pension was cumulative annual sick leave days, more powerful than all other tested determinants together. The degree of explanation for all determinants combined was 96%. Health care utilisation among disability pensioners continued to be high also after disability pension, 2.3 times higher for hospital admissions and 8 times higher for primary health case appointments than among referents. Disability pensioners had lower quality of life than non-pensioners and old age pensioners. For those who became disability pensioners after the baseline measurements quality of life measures decreased progressively until disability pension was granted and were then stabilised on a low level. During follow up 525 (7.6%) subjects died. Compared with subjects who did not become disability pensioners the hazards ratio was 2.78 among women and 3.43 among men, even when the effect of a number of other outcome affecting variables were taken into account. The mortality differences were not explained by underlying disease.

Conclusions. The risk of disability pension may be predicted but only late in the course of events. Disability pensioners continue to have a high level of health care utilisation, and have a worse quality of life development and a higher mortality rate than non-pensioners. Given the unfavourable outcome of disability pension, other means of managing the reduced work capacity might be considered.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 63 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 383
Keyword
Sickness absence, sick leave, disability pension, activity compensation, sickness compensation, early retirement, track record, health care utilisation, complaint score, quality of life, wellbeing, mortality
National Category
Family Medicine
Identifiers
urn:nbn:se:uu:diva-9308 (URN)978-91-554-7300-6 (ISBN)
Public defence
2008-11-06, Enghoffsalen, Ingång 50, Akademiska sjukhuset, Uppsala, 13:15 (English)
Opponent
Supervisors
Available from: 2008-10-16 Created: 2008-10-16 Last updated: 2011-05-13Bibliographically approved

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Wallman, ThorneSvärdsudd, Kurt

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