Łyszczarz Błażej, Wojtasik Jakub
Department of Health Economics, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.
Statistical Analysis Centre & Doctoral School of Social Sciences, Nicolaus Copernicus University in Toruń, Toruń, Poland.
Popul Health Metr. 2025 Jul 2;23(1):35. doi: 10.1186/s12963-025-00400-1.
The COVID-19 pandemic profoundly disrupted workplace attendance, yet its impact on cause-specific work absence remains largely unexplored.
To estimate the cause-specific excess/reduced work absence associated with COVID-19 in Poland.
Following the concept of excess mortality, we define excess work absence as the difference between observed and expected absence, where the latter reflects the level anticipated in the absence of the pandemic. Using time-series analysis (Seasonal Autoregressive Integrated Moving Average) on pre-pandemic (2012-2019) quarterly (Q) social insurance data, we forecasted absence rates for disease groups (classified by ICD-10 chapters) and caregiving-related absenteeism. Forecasted absence rates were then compared to observed values during 2020-2024, allowing for the identification of excess or reduced work absence.
We observed notable deviations in work absence rates during the pandemic period (until the end of Q1-2022). The highest excess absence was identified in caregiving-related absenteeism at the pandemic's onset, exceeding expected levels by over fivefold. A mental health crisis that began with the pandemic resulted in four consecutive quarters of excess absence, reaching a 54% excess in Q2-2020. We identified a notable excess absence in three ICD-10 chapters that reflect the indirect effects of the pandemic, such as increased diagnostic uncertainty, modified coding practices during early COVID-19 waves, and widespread implementation of public health interventions. Absence rates were lower than expected in neoplasms, endocrine and digestive diseases until the end of the pandemic period, likely reflecting reduced healthcare accessibility. Similarly, absence related to injuries and poisoning was below the expected level until mid-2022, indicating decreased social mobility.
COVID-19 substantially reshaped work absence patterns in Poland, particularly during the early pandemic phase. Pronounced increases and decreases were identified across disease categories. These diverging trends plausibly reflect both the COVID-19's effects on the development of other conditions and disruptions in healthcare access. These findings highlight the need for disease-specific policy responses to mitigate future health crises and ensure continuity of care during pandemics.
新冠疫情严重扰乱了职场出勤情况，但其对特定病因导致的工作缺勤的影响在很大程度上仍未得到充分研究。
估计波兰与新冠疫情相关的特定病因导致的工作缺勤过多/减少情况。
遵循超额死亡率的概念，我们将超额工作缺勤定义为观察到的缺勤与预期缺勤之间的差异，其中后者反映了在没有疫情的情况下预期的水平。利用疫情前（2012 - 2019年）季度社会保险数据进行时间序列分析（季节性自回归积分移动平均模型），我们预测了疾病组（按国际疾病分类第10版章节分类）和与照顾相关的缺勤率。然后将预测的缺勤率与2020 - 2024年期间观察到的值进行比较，从而确定工作缺勤过多或减少的情况。
我们观察到疫情期间（直至2022年第一季度末）工作缺勤率出现显著偏差。在疫情开始时，与照顾相关的缺勤中发现的超额缺勤最高，但超过预期水平五倍多。疫情引发的心理健康危机导致连续四个季度出现超额缺勤，在2020年第二季度达到54%的超额。我们在国际疾病分类第10版的三个章节中发现了显著的超额缺勤情况，这些章节反映了疫情的间接影响，如诊断不确定性增加、新冠疫情早期波次期间编码实践的改变以及公共卫生干预措施的广泛实施。直到疫情结束，肿瘤、内分泌和消化系统疾病的缺勤率低于预期，这可能反映了医疗可及性的降低。同样，与受伤和中毒相关的缺勤在2022年年中之前低于预期水平，表明社会流动性下降。
新冠疫情极大地重塑了波兰的工作缺勤模式，尤其是在疫情早期阶段。在不同疾病类别中发现了明显的增加和减少情况。这些不同的趋势可能既反映了新冠疫情对其他疾病发展的影响，也反映了医疗服务获取方面的中断。这些发现凸显了针对特定疾病制定政策应对措施的必要性，以减轻未来的健康危机，并确保在疫情期间医疗服务的连续性。
