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Health care utilisation before and after retirement due to illness - A 13-year population-based follow-up study of prematurely retired men and referents from the general population
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 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, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
2004 (English)In: Scand J Prim Health Care, ISSN 0281-3432, Vol. 22, no 2, 95-100 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2004. Vol. 22, no 2, 95-100 p.
Identifiers
URN: urn:nbn:se:uu:diva-97612DOI: 10.1080/02813430410005126OAI: oai:DiVA.org:uu-97612DiVA: diva2:172624
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, ThorneBurell, GunillaSvärdsudd, Kurt

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