Aaviksoo Evelyn, Kiivet Raul Allan
University of Tartu, Department of Public Health, Ravila 19, 50411 Tartu, Estonia.
Health Policy. 2016 Sep;120(9):1070-8. doi: 10.1016/j.healthpol.2016.07.014. Epub 2016 Jul 26.
To analyse short-term changes in sick-leave use after the implementation of sick-pay cut policy in Estonia on July 1, 2009.
The study is based on all sick-leave episodes of 20-64-year-old employees registered by the Estonian Health Insurance Fund in 2008 and 2011, which covers 227,981 persons in 2008 and 152,102 persons in 2011. Population- and absentee-level sickness absence measures were used to describe sickness absence. Multiple logistic regression analysis was performed to explore associations between sick-pay cut and sickness absence measures.
The main impact of the reform was that the total number of sick-leave episodes and sick-listed persons decreased by one third. The number of sick leave episodes lasting 4-20days decreased by half whereas the change in shorter and longer episodes was negligible. Chances of recurrent sick-leave lowered significantly. The mean duration of sick-leave episodes lengthened in a positive correlation with age.
At the population level sickness absence decreased after the sick-pay cut, which was one of the goals of the reform. The sickness absence of absentees with long-lasting illnesses did not change, but people with shorter illnesses adapted their sickness absence behaviour. It indicates that health outcomes of people whose absence has decreased due to policy changes need to be followed.
分析2009年7月1日爱沙尼亚实施病假工资削减政策后病假使用情况的短期变化。
该研究基于爱沙尼亚健康保险基金登记的2008年和2011年20至64岁员工的所有病假记录，2008年涵盖227,981人，2011年涵盖152,102人。采用总体和缺勤层面的病假衡量指标来描述病假情况。进行多因素逻辑回归分析以探究病假工资削减与病假衡量指标之间的关联。
改革的主要影响是病假记录总数和列入病假名单的人数减少了三分之一。持续4至20天的病假记录数量减少了一半，而较短和较长病假记录的变化可忽略不计。再次请病假的几率显著降低。病假记录的平均时长延长，且与年龄呈正相关。
在总体层面，病假工资削减后病假情况有所减少，这是改革目标之一。长期患病员工的病假情况未改变，但患病时间较短的员工调整了他们的病假行为。这表明需要关注因政策变化而病假减少的人群的健康状况。
