Voss M, Floderus B, Diderichsen F
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Scand J Public Health. 2001 Sep;29(3):166-74.
In 1993, a qualifying day without sickness benefit was introduced to the Swedish sickness benefit system. The aim of the present study is to investigate sickness absenteeism before and after the introduction of the qualifying day, in the light of conditions inside and outside working life.
The study was based on 1,952 female and 2,229 male employees of Sweden Post. Sickness absence was measured by sickness incidence one year before and one year after the introduction of the qualifying day (sick-leave events/person days at risk). Information about explanatory factors was collected by a postal questionnaire in 1994.
A decrease in sickness incidence was observed after the introduction of the qualifying day as well as an increase in the mean duration of sick-leave events. The proportion of long-term sick-leave events (15-365 days) increased; among men this increase was also found in absolute terms. There were no suggestions of economy being an important determinant for reduced sickness incidence. Women with long-term or serious disease did not show a reduction of sickness incidence to the same extent as those without disease, and for men a coherent result was observed. Men with heavy lifting at work more often showed an increase in incidence compared to men without heavy lifting, and the same tendency was found for women.
The reduction in sickness incidence following the introduction of the qualifying day was fairly independent of different work-related and non-work-related factors. The impact of the qualifying day differed depending on health status and the physical workload.
1993年,瑞典疾病保险制度引入了无疾病保险金资格日。本研究的目的是根据工作生活内外的条件,调查资格日引入前后的病假缺勤情况。
该研究基于瑞典邮政的1952名女性和2229名男性员工。通过资格日引入前一年和引入后一年的疾病发病率(病假事件/危险人日)来衡量病假缺勤情况。1994年通过邮政问卷收集有关解释因素的信息。
资格日引入后,疾病发病率下降,病假事件的平均持续时间增加。长期病假事件(15 - 365天)的比例增加;男性的这一增加在绝对数量上也有所体现。没有迹象表明经济是疾病发病率降低的重要决定因素。患有长期或严重疾病的女性与未患病女性相比,疾病发病率没有同等程度的降低,男性则呈现出一致的结果。与无重物搬运工作的男性相比,从事重物搬运工作的男性发病率更常出现增加,女性也有同样的趋势。
资格日引入后疾病发病率的降低在很大程度上独立于不同的工作相关和非工作相关因素。资格日的影响因健康状况和体力工作量而异。