Kausto Johanna, Pentti Jaana, Oksanen Tuula, Virta Lauri J, Virtanen Marianna, Kivimäki Mika, Vahtera Jussi
Finnish Institute of Occupational Health, PL 40, 00251 Helsinki, Finland.
Scand J Work Environ Health. 2017 Jul 1;43(4):358-366. doi: 10.5271/sjweh.3643. Epub 2017 May 2.
Objectives The aim of this study was to investigate the association between the length of sickness absence and sustained return to work (SRTW) and the predictors of SRTW in depression, anxiety disorders, intervertebral disc disorders, and back pain in a population-based cohort of employees in the Finnish public sector. Methods We linked data from employers' registers and four national population registers. Cox proportional hazards regression analysis with a cluster option was applied. SRTW was defined as the end of the sickness benefit period not followed by a recurrent sickness benefit period in 30 days. Results For depression, the median time to SRTW was 46 and 38 days among men and women, respectively. For anxiety disorders, the figures were 24 and 22 days, for intervertebral disc disorders, 42 and 41 days, and, for back pain, 21 and 22 days among men and women respectively. Higher age and the persistence of the health problem predicted longer time to SRTW throughout the diagnostic categories. Comorbid conditions predicted longer time to SRTW in depression and back pain among women. Conclusions This large cohort study adds scientific evidence on the length of sickness absence and SRTW in four important diagnostic categories among public sector employees in Finland. Further research taking into account, eg, features of the work environment is suggested. Recommendations on the length of sickness absence at this point should be based on expert opinion and supplemented with research findings.
目的 本研究旨在调查芬兰公共部门员工队列中，抑郁症、焦虑症、椎间盘疾病和背痛患者的病假时长与持续恢复工作（SRTW）之间的关联，以及SRTW的预测因素。方法 我们将雇主登记册数据与四个国家人口登记册数据相链接。应用带有聚类选项的Cox比例风险回归分析。SRTW被定义为病假津贴期结束后30天内无复发病假津贴期。结果 对于抑郁症，男性和女性的SRTW中位时间分别为46天和38天。对于焦虑症，相应数字分别为24天和22天；对于椎间盘疾病，分别为42天和41天；对于背痛，男性和女性分别为21天和22天。在所有诊断类别中，年龄较大和健康问题持续存在预示着SRTW时间较长。合并症预示着女性抑郁症和背痛患者的SRTW时间较长。结论 这项大型队列研究为芬兰公共部门员工四个重要诊断类别的病假时长和SRTW提供了科学证据。建议进一步开展研究，例如考虑工作环境的特点。目前关于病假时长的建议应以专家意见为基础，并辅以研究结果。
