Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Acta Neurol Scand. 2022 Sep;146(3):283-294. doi: 10.1111/ane.13664. Epub 2022 Jul 4.
Early withdrawal from work is common among people with multiple sclerosis (PwMS). However, little is known about how this is influenced by the type of employment. The aims were to explore the distributions of self-employed and other types of employment (employed or no earnings from work) before and after MS diagnosis and its associations with sickness absence (SA) and disability pension (DP) among PwMS and matched references without MS.
MATERIALS & METHOD: A 6-year longitudinal cohort study of 2779 individuals diagnosed with MS in 2008-2012 when aged 20-59 and of 13,863 matched individuals without MS from Sweden's population was conducted. Hazard ratios (HR) of >180 SA and/or DP days/year were compared by employment status among PwMS and references using Cox proportional hazard models with 95% confidence intervals (CI).
Most had no SA or DP. Nevertheless, PwMS had higher SA and DP levels compared with references. PwMS had a higher likelihood to reach >180 days of SA (HR = 4.89, 95% CI = 4.43-5.40) or days of DP (HR = 6.31, 95% CI = 5.46-7.30), irrespective of the employment status. Self-employed references had less likelihood for >180 SA days than employed references. However, self-employed and employed PwMS had a similar likelihood for >180 SA days. Transitions of employees to self-employment were infrequent among PwMS (1.7%) and references (2.6%).
PwMS transit to SA and DP to a higher extent than references. In contrast to individuals without MS, self-employed PwMS had similar SA levels to employed PwMS. Switching to self-employment was not a predominant choice for people recently diagnosed with MS.
多发性硬化症（MS）患者常提前退出工作。然而，人们对这种情况受何种就业类型影响知之甚少。本研究旨在探讨 MS 诊断前后自雇和其他类型就业（有工作或无工作收入）的分布情况，并比较 MS 患者与匹配的无 MS 对照者的病假（SA）和残疾抚恤金（DP）缺勤率。
本研究为一项 6 年纵向队列研究，纳入 2008-2012 年间诊断为 MS 的 2779 名年龄在 20-59 岁的个体和来自瑞典人群的 13863 名匹配的无 MS 对照者。采用 Cox 比例风险模型比较 MS 患者和对照者的不同就业状态下 SA 和/或 DP 缺勤率（>180 天/年），并计算风险比（HR）及其 95%置信区间（CI）。
大多数患者没有 SA 或 DP。然而，MS 患者的 SA 和 DP 缺勤率均高于对照者。无论就业状态如何，MS 患者的 SA 缺勤率（HR=4.89，95%CI=4.43-5.40）或 DP 缺勤率（HR=6.31，95%CI=5.46-7.30）均较高。与有工作的对照者相比，自雇的对照者 SA 缺勤率较低。然而，自雇和有工作的 MS 患者的 SA 缺勤率相似。MS 患者和对照者中，从雇员转为自雇者的情况都很少见（分别为 1.7%和 2.6%）。
MS 患者比对照者更易过渡到 SA 和 DP。与无 MS 的个体不同，自雇的 MS 患者与有工作的 MS 患者的 SA 缺勤率相似。最近诊断为 MS 的患者通常不会选择转为自雇。
