挪威关于实现更具包容性工作生活的协议对孕妇病假和孕产福利使用情况的影响：一项队列研究

Effect of the Norwegian agreement on a more inclusive working life on use of sick leave and pregnancy benefits among pregnant women: a cohort study.

作者信息

Hasting Rachel Louise, Hoff Rune, Merkus Suzanne L, Gran Jon Michael, Mehlum Ingrid S

机构信息

Research Group for Occupational Medicine and Epidemiology, National Institute of Occupational Health, Majorstuen, Oslo, 5330, 0304, PB, Norway.

Research Group for Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway.

出版信息

BMC Public Health. 2024 Dec 19;24(1):3536. doi: 10.1186/s12889-024-20933-8.

DOI:10.1186/s12889-024-20933-8

PMID:39702039

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11660774/

Abstract

BACKGROUND

We aimed to estimate the effect of the voluntary Norwegian Agreement on a More Inclusive Working Life (IA Agreement) on use of sickness absence (SA) and pregnancy benefits among pregnant women.

METHODS

Pregnant women (n = 112,486) with a birth during 1.12.2003-31.12.2010 were followed from 6 to 37 gestational weeks in a continuous time multistate model with the following states: work, full SA, graded SA, pregnancy benefits, maternity leave, and other. Women working in IA companies were compared to those in non-IA companies regarding incidence and duration of SA and pregnancy benefits. Differences between groups with respect to calendar year, age, civil status, education, industry, and number of employees in the company were adjusted for using inverse probability of treatment weighting. Absolute differences in probabilities over time, expected length of stay (ELOS) in each state and differences in ELOS between IA and non-IA were calculated. 95% confidence intervals (CI) were generated using bootstrapping (1,000 repetitions).

RESULTS

Adjusted analyses suggest that women working in IA companies were more likely to be in full SA in the first and last trimesters, but less likely between 14 and 28 weeks, than those in non-IA companies. The probability of being in work mirrored this, with women in IA companies tending to spend half a day more in work (ELOS difference 0.55, 95% CI -1.79, 3.02). Differences were not statistically significant. The use of graded SA was slightly higher (ELOS difference 0.46, 95% CI -0.87, 1.72) and the use of pregnancy benefits slightly lower (ELOS difference - 0.43, 95% CI -1.32, 0.42) among those in IA companies compared to non-IA companies.

CONCLUSIONS

Women in IA companies tended to spend more time in work and graded SA, but less time on pregnancy benefits. Differences in full SA varied during pregnancy and were most positive mid-pregnancy. This indicates that IA measures could be more effective for conditions experienced at this point. However, effects were small and not statistically significant, which may indicate the IA Agreement has not focused much on pregnant women.

KEY TERMS

IA Agreement, MBRN, MoBa, multistate models, pregnancy, pregnancy benefits, sickness absence, work participation.

摘要

背景

我们旨在评估挪威自愿性《更具包容性工作生活协议》（IA协议）对孕妇病假缺勤（SA）使用情况及孕产福利的影响。

方法

对在2003年12月1日至2010年12月31日期间分娩的112,486名孕妇进行跟踪，从孕6周到孕37周，采用连续时间多状态模型，状态包括：工作、全薪病假、分级病假、孕产福利、产假及其他。将在IA公司工作的女性与非IA公司的女性在SA和孕产福利的发生率及持续时间方面进行比较。使用治疗权重的逆概率对各年份、年龄、婚姻状况、教育程度、行业及公司员工数量等组间差异进行调整。计算随时间变化的概率绝对差异、各状态下的预期停留时长（ELOS）以及IA公司与非IA公司之间的ELOS差异。使用自抽样法（重复1000次）生成95%置信区间（CI）。

结果

调整分析表明，与非IA公司的女性相比，在IA公司工作的女性在孕早期和孕晚期更有可能处于全薪病假状态，但在孕14至28周期间可能性较小。工作概率情况与之相反，IA公司的女性在工作上的时间往往多半天（ELOS差异0.55，95%CI -1.79，3.02）。差异无统计学意义。与非IA公司相比，IA公司的女性分级病假使用率略高（ELOS差异0.46，95%CI -0.87，1.72），孕产福利使用率略低（ELOS差异 -0.43，95%CI -1.32，0.42）。