| 1. |
- Gjesdal, S, et al.
(författare)
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Sickness absence with musculoskeletal or mental diagnoses, transition into disability pension and all-cause mortality: a 9-year prospective cohort study
- 2009
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:4, s. 387-394
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Increased early mortality indicates poor health. This study assessed mortality among men and women after long-term sickness absence (LTSA) with musculoskeletal or mental diagnoses. A special focus was on possible differences in mortality among women and men who obtained disability pension (DP) as compared to those who did not. Methods: This was a 9-year prospective cohort study in Hordaland County, Norway, including 1417 women and 1075 men aged 16—62 years with a spell of LTSA 48 weeks, and with a musculoskeletal or mental diagnosis. The endpoint was death from all causes. Age-standardised mortality rates for those who obtained DP and those who did not were calculated and compared. Cox proportional hazards analysis was used to assess DP status and other possible predictors of premature death. All analyses were stratified for gender. Results: Overall, 36% obtained a DP and 3.2% died. Among the men, 7.2% with mental diagnoses and 4.4% with musculoskeletal sick-leave diagnoses died. Among the women, 1.9% died in both groups. Among the men, 5.6% of the DP recipients died, as compared to 4.6% among those without DP. The respective figures for the women were 2.9% and 1.3%. Male gender, increasing age and low income among men increased the mortality risk significantly. After adjustments for these variables, the hazard ratios associated with DP were 2.9 (95% confidence interval (CI) 1.2—7.0) for women and 2.3 (95% CI 1.2—4.5) for men. Conclusions: When monitoring those on LTSA, one should be aware of the high mortality among those who obtain DP and male workers with low income, and preventive actions should be considered.
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| 2. |
- Hyde, M, et al.
(författare)
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Bridges, pathways and valleys: labour market position and risk of hospitalization in a Swedish sample aged 55-63
- 2004
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 32:5, s. 368-373
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Tidskriftsartikel (refereegranskat)abstract
- Background: The combination of population ageing and increasingly early labour market exit (LME) throughout Europe has made older age a key issue in social policy and research. There is increasing awareness that older people are a heterogeneous group in which health inequalities persist. However, the effects of different types of LME on health have received relatively little attention. Existing studies reach different conclusions. This might be due to several reasons: different types of LME are rarely explored in conjuncture; studies often lack objective assessments of health and frequently rely on small populations. This paper aims to test the relative effects of different LME on the risk of hospitalization compared with those who remained in paid employment. Methods: Using Government register data on pooled cross-section samples of Swedish workers aged 55 - 63 years (n=7,024) the authors have compared the likelihood of hospitalization for three types of LME - disability pension (förtidpension), unemployment, and early retirement - with those who continue working. Results: Controlling for previous hospitalization, sex, age, social class, and health at work a significant increased risk of hospitalization was found following LME for the unemployed (OR=1.98). Conclusion: Early LME is a varied process with mixed effects on health, and hence is of possible importance for policy, which, therefore, requires more attention. Programmes to help older unemployed workers back into work will have positive health effects for individuals and reduce welfare costs of hospitalization.
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| 3. |
- Salmi, P, et al.
(författare)
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Multidisciplinary investigations recognize high prevalence of co-morbidity of psychiatric and somatic diagnoses in long-term sickness absentees
- 2009
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:1, s. 35-42
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Tidskriftsartikel (refereegranskat)abstract
- Aims: In Sweden, the Social Insurance Offices each year refer long-term sickness absentees to comprehensive investigations to clarify medical conditions. However, there is a lack of scientific knowledge about these patients and their morbidity. The aim was to characterize a population of these sickness absentees regarding prevalence of somatic and psychiatric diagnoses and possible associations with sociodemographic, lifestyle, and health characteristics. Methods: A cross-sectional study was made up of 635 sickness absentees below the age of 64, who the local Social Insurance Offices in Stockholm County, Sweden, referred to a special unit for multidisciplinary investigation. Data was obtained from questionnaires and medical records. The patients were examined by board certified specialists in psychiatry, orthopaedic surgery, and rehabilitation medicine. Relative risks were estimated by use of modified Poisson regression to assess the associations between characteristics and diagnose outcomes. Results: About 80% of the patients had more than one diagnosis. The vast majority had a psychiatric diagnosis, and approximately 55% had that in combination with at least one somatic diagnosis. An increased risk for being given a psychiatric diagnosis was found for men and unemployed people. In addition, lack of social life and friends and self-reported mental health problems were associated with psychiatric diagnoses but also among those who were given somatic diagnoses in combination with psychiatric diagnoses. Increased risks for somatic diagnoses were found for women and for patients with a higher education. Conclusions: Long-term sickness absentees referred to multidisciplinary investigations display high co-morbidity of psychiatric and somatic diagnoses and are a heterogeneous group with diverse sociodemographic and medical characteristics.
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| 4. |
- Svedberg, P, et al.
(författare)
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Does multidisciplinary assessment of long-term sickness absentees result in modification of sick-listing diagnoses?
- 2010
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:6, s. 657-663
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim was to study whether sick-leave diagnoses of long-term sickness absentees were modified after a multidisciplinary assessment and if modifications differed with type of medical specialty of the latest physician to sick-list the patient. Methods: A sample of 635 long-term sickness absentees referred to a multidisciplinary assessment by Social Insurance Offices was included. Data were obtained through sickness certificates and medical records. Patients were examined by board-certified specialists in psychiatry, orthopaedic surgery, and rehabilitation medicine. Descriptive statistics were used. Results: The multidisciplinary assessment resulted in an increase from 1—2 to 2—3 diagnoses for most patients. Forty-five per cent of the male and 47% of the female patients had only somatic diagnoses at referral. After the multidisciplinary assessment these percentages were 20% and 29%, respectively. The rate of women and men given both psychiatric and somatic diagnoses increased from 30% at referral to about 55%. The shift from either only psychiatric or only somatic diagnoses to having these diagnoses in combination was associated with type of specialty of the physician who had sick-listed the patient. Conclusions: The study indicates that many patients on long-term sick-leave with unclear diagnoses may suffer from unrecognized, and therefore probably untreated, medical disorders and co-morbidity.
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