Centre for Health Equity Studies (CHESS)/Swedish Institute for Social Research (SOFI), Stockholm University, 10691 Stockholm, Sweden.
Soc Sci Med. 2017 Mar;177:158-168. doi: 10.1016/j.socscimed.2017.01.042. Epub 2017 Jan 28.
Sickness absence is associated with great costs for individuals, companies and society at large. Influenced by neo-classical economic theory, policy advice has emphasized the role of sickness benefit programs for reducing sickness absence rates: too generous benefits without proper control will increase the number of recipients and prolong absence spells as well as possibly cause negative dynamic effects in the long term. This study provides an alternative interpretation of the relationship between sickness benefits and sickness absence. By combining an epidemiological approach to sickness absence and a resource-based approach to welfare, we argue that sickness benefits might be viewed as a "collective resource" that, by providing economic support during times of ill-health, might have positive health effects. Statistical analysis of short-term sickness absence using innovative methodological approaches and combined micro- and macro-level data for 21 EU countries over the period of 1992-2011 indicates that the long run effects of relatively generous sickness benefits is rather to reduce sickness absence. This result also has implications for sickness benefit reform: whereas benefit cuts to some extent may reduce absence in the short run, in the longer run such reforms may actually increase sickness absence rates.
病假与个人、公司和整个社会的巨大成本有关。受新古典经济理论的影响，政策建议强调了病假福利计划在降低病假率方面的作用：福利过于慷慨而没有适当的控制，将增加受益人数并延长病假时间，并且从长期来看可能会产生负面的动态效应。本研究对病假福利与病假之间的关系提供了另一种解释。通过将流行病学方法应用于病假和基于资源的福利方法相结合，我们认为病假福利可以被视为一种“集体资源”，通过在患病期间提供经济支持，可能会产生积极的健康影响。使用创新的方法对 21 个欧盟国家在 1992-2011 年期间的短期病假进行统计分析，结果表明，相对慷慨的病假福利的长期影响是减少病假。这一结果也对病假福利改革具有启示意义：虽然福利削减在一定程度上可能会减少短期的缺勤，但从长期来看，此类改革实际上可能会增加病假率。
