| 1. |
- Bergsten, Eva L., 1969-, et al.
(author)
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Fall and collision related injuries among pedestrians, sickness absence and associations with accident type and occupation
- 2023
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In: Journal of Safety Research. - : Elsevier. - 0022-4375 .- 1879-1247. ; 86, s. 357-363
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Journal article (peer-reviewed)abstract
- Objectives: This study explores pedestrian fall accidents and collisions with other road users in the Swedish road transport system, and sickness absence (SA) in relation to accident type, injury, and occupation. Further, it studies the associations between accident type, occupation, and duration of SA. Methods: Data from several national registers were used that included 15,359 working age pedestrians (20–64 years) receiving healthcare after a fall or collision throughout 2014–2016. Individual characteristics, accident type, injury, and occupation were presented and related to SA. Logistic regression was used to estimate odds ratios (OR), with 95% confidence intervals, for associations between accident type, occupation, and SA duration. Results: About 11,000 pedestrians (72%) were involved in fall accidents in the road traffic environment and well over 4,000 in collisions with another road user; 22% of all injured pedestrians had a new SA. The population had a higher proportion of women and individuals in older age groups (≥45). Of the falls, 31% were due to snow or ice, and these were associated with a higher OR for both short SA (<90 days) 1.76 (95% CI 1.56–1.98) and long SA (≥90 days) 1.81 (95% CI 1.51–2.18), compared to the group slipping, tripping, and stumbling. The working sectors health & social care, and construction had the highest ORs for SA. A higher OR was found for health & social care, short SA 1.58 (95% CI 1.38–1.81), long SA 1.79 (95% CI 1.45–2.20) and for construction, short SA 1.56 (95% CI 1.24–1.96), long SA 1.75 (95% CI 1.26–2.44), compared to the sector finance, communication, & cultural service. Conclusions: The OR for having short and long SA was higher in falls due to snow or ice and differed between occupational sectors. Practical implications: This information contributes to the knowledge base for planning a safe road transport system for pedestrians.
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| 2. |
- Bergsten, Eva L., 1969-, et al.
(author)
-
Fall and collision related injuries among pedestrians, sickness absence and associations with accident type and occupation
- 2023
-
In: Journal of Safety Research. - : Elsevier. - 0022-4375 .- 1879-1247. ; 86, s. 357-363
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: This study explores pedestrian fall accidents and collisions with other road users in the Swedish road transport system, and sickness absence (SA) in relation to accident type, injury, and occupation. Further, it studies the associations between accident type, occupation, and duration of SA.METHODS: Data from several national registers were used that included 15,359 working age pedestrians (20-64 years) receiving healthcare after a fall or collision throughout 2014-2016. Individual characteristics, accident type, injury, and occupation were presented and related to SA. Logistic regression was used to estimate odds ratios (OR), with 95% confidence intervals, for associations between accident type, occupation, and SA duration.RESULTS: About 11,000 pedestrians (72%) were involved in fall accidents in the road traffic environment and well over 4,000 in collisions with another road user; 22% of all injured pedestrians had a new SA. The population had a higher proportion of women and individuals in older age groups (≥45). Of the falls, 31% were due to snow or ice, and these were associated with a higher OR for both short SA (<90 days) 1.76 (95% CI 1.56-1.98) and long SA (≥90 days) 1.81 (95% CI 1.51-2.18), compared to the group slipping, tripping, and stumbling. The working sectors health & social care, and construction had the highest ORs for SA. A higher OR was found for health & social care, short SA 1.58 (95% CI 1.38-1.81), long SA 1.79 (95% CI 1.45-2.20) and for construction, short SA 1.56 (95% CI 1.24-1.96), long SA 1.75 (95% CI 1.26-2.44), compared to the sector finance, communication, & cultural service.CONCLUSIONS: The OR for having short and long SA was higher in falls due to snow or ice and differed between occupational sectors.PRACTICAL IMPLICATIONS: This information contributes to the knowledge base for planning a safe road transport system for pedestrians.
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| 3. |
- Björkenstam, Emma, et al.
(author)
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Associations between childbirth, hospitalization and disability pension : a cohort study of female twins
- 2014
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:7
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Journal article (peer-reviewed)abstract
- BACKGROUND: As the literature on long-term effects of childbirth on risk of morbidity or permanent work incapacity (DP) is limited, we aimed to study associations of childbirth with hospitalization and DP, adjusting for familial factors.METHODS: This cohort study included female twins, i.e. women with twin sister, born 1959-1990 in Sweden (n = 5 118). At least one in the twin pair had their first childbirth 1994-2009. Women were followed regarding all-cause and cause-specific (mental or musculoskeletal diagnoses) DP during year 2-5 after first delivery or equivalent. Associations between childbirth, hospitalization and DP were calculated as hazard ratios (HR) with 95% confidence intervals (CI).RESULTS: Women who did not give birth had markedly higher number of DP days/year compared to those giving birth. Hospitalization after first childbirth was associated with a higher HR of DP. Those hospitalized at least once after their first childbirth had a three-fold DP risk (HR: 3.2; 95% CI 1.1-9.6), DP due to mental diagnoses (HR: 3.2; 1.2-8.8), and of DP due to musculoskeletal diagnoses (HR: 6.1; 1.6-22.9). Lower HRs in the discordant twin pair analyses indicated that familial factors may influence the studied associations.CONCLUSIONS: Women who did not give birth had a much higher risk for DP than those who did. Among those who gave birth, the risk for DP was markedly higher among those with a previous hospitalization, and especially in women with repeated hospitalizations. The results indicate a health selection into giving birth as well as the importance of morbidity for DP.
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| 4. |
- Björkenstam, Emma, et al.
(author)
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Childbirth, hospitalisation and sickness absence : a study of female twins
- 2015
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 5:1
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate associations of giving birth with morbidity in terms of hospitalisation and social consequences of morbidity in terms of sickness absence (SA), while taking familial (genetics and shared environmental) factors into account.DESIGN: Prospective register-based cohort study. Estimates of risk of hospitalisation and SA were calculated as HRs with 95% CIs.SETTING: All female twins, that is, women with a twin sister, born in Sweden.PARTICIPANTS: 5118 Swedish female twins (women with a twin sister), born during 1959-1990, where at least one in the twin pair had their first childbirth (T0) during 1994-2009 and none gave birth before 1994.MAIN OUTCOME MEASURES: Hospitalisation and SA during year 3-5 after first delivery or equivalent.RESULTS: Preceding the first childbirth, the mean annual number of SA days increased for mothers, and then decreased again. Hospitalisation after T0 was associated with higher HRs of short-term and long-term SA (HR for short-term SA 3.0; 95% CI 2.5 to 3.6 and for long-term SA 2.3; 95% CI 1.6 to 3.2). Hospitalisation both before and after first childbirth was associated with a higher risk of future SA (HR for long-term SA 4.2; 95% CI 2.7 to 6.4). Familial factors influenced the association between hospitalisation and long-term SA, regardless of childbirth status.CONCLUSIONS: Women giving birth did not have a higher risk for SA than those not giving birth and results indicate a positive health selection into giving birth. Mothers hospitalised before and/or after giving birth had higher risks for future SA, that is, there was a strong association between morbidity and future SA.
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| 5. |
- Bondesson, Tina, et al.
(author)
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A study to examine the influence of health professionals' advice and support on work capacity and sick leave after breast cancer surgery
- 2016
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In: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 24:10, s. 4141-4148
-
Journal article (peer-reviewed)abstract
- PURPOSE: The aim of this study was to investigate how women, shortly after breast cancer surgery, experienced encounters with, and information from, healthcare professionals regarding work and sick leave and if these experiences were associated with self-reported work capacity and sick leave.METHODS: This is a cross-sectional study based on questionnaire data from 605 women who had had breast cancer surgery, aged 20-63 years. Exclusion criteria were known distant metastases, pre surgical therapy, and/or previous breast cancer. Data on age, type of surgery, global health, and work environment were included as covariates in multivariable logistic regression analysis.RESULTS: Five percent of the women had not received any advice concerning work or sick leave. Women reporting receiving useful advice or support related to paid work had lower risk of reporting reduced physical or psychological/social work capacity due to the cancer or treatment (OR 0.46 (95 % CI 0.26-0.81) respective OR 0.45 (95 % CI 0.26-0.77)). There were no associations between having received useful advice or support concerning work and being on sick leave. Women encouraged to take sick leave had an OR of 2.17 (95 % CI 1.39-3.37) of being sickness absent. They also to a higher extent had reduced physical and psychological/social work capacity. Women who reported to have been encouraged to work were sickness absent to a lower extent (OR 0.64; 95 % CI 0.41-0.98) and reported higher physical work capacity.CONCLUSIONS: Work and sick leave is being discussed during consultations with women with breast cancer and the advice given seems to be in line with the women's subjective work capacity.
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| 6. |
- Bondesson, Tina, et al.
(author)
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A study to examine the influence of health professionals' advice and support on work capacity and sick leave after breast cancer surgery
- 2016
-
In: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 24:10, s. 4141-4148
-
Journal article (peer-reviewed)abstract
- PURPOSE: The aim of this study was to investigate how women, shortly after breast cancer surgery, experienced encounters with, and information from, healthcare professionals regarding work and sick leave and if these experiences were associated with self-reported work capacity and sick leave.METHODS: This is a cross-sectional study based on questionnaire data from 605 women who had had breast cancer surgery, aged 20-63 years. Exclusion criteria were known distant metastases, pre surgical therapy, and/or previous breast cancer. Data on age, type of surgery, global health, and work environment were included as covariates in multivariable logistic regression analysis.RESULTS: Five percent of the women had not received any advice concerning work or sick leave. Women reporting receiving useful advice or support related to paid work had lower risk of reporting reduced physical or psychological/social work capacity due to the cancer or treatment (OR 0.46 (95 % CI 0.26-0.81) respective OR 0.45 (95 % CI 0.26-0.77)). There were no associations between having received useful advice or support concerning work and being on sick leave. Women encouraged to take sick leave had an OR of 2.17 (95 % CI 1.39-3.37) of being sickness absent. They also to a higher extent had reduced physical and psychological/social work capacity. Women who reported to have been encouraged to work were sickness absent to a lower extent (OR 0.64; 95 % CI 0.41-0.98) and reported higher physical work capacity.CONCLUSIONS: Work and sick leave is being discussed during consultations with women with breast cancer and the advice given seems to be in line with the women's subjective work capacity.
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| 7. |
- Bränström, Richard, et al.
(author)
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Reasons for and factors associated with issuing sickness certificates for longer periods than necessary : results from a nationwide survey of physicians.
- 2013
-
In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13, s. 478-
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Physicians' work with sickness certifications is an understudied field. Physicians' experience of sickness certifying for longer periods than necessary has been previous reported. However, the extent and frequency of such sickness certification is largely unknown. The aims of this study were: a) to explore the frequency of sickness certifying for longer periods than necessary among physicians working in different clinical settings; b) to examine main reasons for issuing sickness certificates for longer periods than necessary; and c) to examine factors associated with unnecessary issued sickness certificates.METHODS: In 2008, all physicians living and working in Sweden (a total of 36,898) were sent an invitation to participate in a questionnaire study concerning their sick-listing practices. A total of 22,349 (60.6%) returned the questionnaire. In the current study, physicians reporting handling sickness certification consultations at least weekly were included in the analyses, a total of 12,348.RESULTS: The proportion of physicians reporting issuing sickness certificates for longer periods than actually necessary varied greatly between different types of clinics, with the highest frequency among those working at: occupational medicine, orthopedic, primary health care, and psychiatry clinics; and lowest among those working in: eye, dermatology, ear/nose/throat, oncology, surgery, and infection clinics. Logistic analyses showed that sickness certifying for longer periods than necessary due to limitations in the health care system was particularly common among physicians working at occupational medicine, orthopedic, and primary health care clinics. Sickness certifying for longer periods than necessary due to patient-related factors was much more common among physicians working at psychiatric clinics. In addition to differences between clinics, frequency of sickness certificates issued for longer periods than necessary varied by age, physicians' experiences of different situations, and perceived problems.CONCLUSIONS: This study showed that physicians issued sickness certificates for longer periods than actually necessary quite frequently at some types of clinics. Differences between clinics were to a large extent associated with frequency of problems, lack of time, delicate interactions with patients, and need for more competence.
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| 8. |
- Bränström, Richard, et al.
(author)
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Reasons for and factors associated with issuing sickness certificates for longer periods than necessary : Results from a nationwide survey of physicians
- 2013
-
In: BMC Public Health. - : Springer Nature. - 1471-2458. ; 13
-
Journal article (peer-reviewed)abstract
- BackgroundPhysicians' work with sickness certifications is an understudied field. Physicians' experience of sickness certifying for longer periods than necessary has been previous reported. However, the extent and frequency of such sickness certification is largely unknown. The aims of this study were: a) to explore the frequency of sickness certifying for longer periods than necessary among physicians working in different clinical settings; b) to examine main reasons for issuing sickness certificates for longer periods than necessary; and c) to examine factors associated with unnecessary issued sickness certificates.Methods In 2008, all physicians living and working in Sweden (a total of 36,898) were sent an invitation to participate in a questionnaire study concerning their sick-listing practices. A total of 22,349 (60.6%) returned the questionnaire. In the current study, physicians reporting handling sickness certification consultations at least weekly were included in the analyses, a total of 12,348.ResultsThe proportion of physicians reporting issuing sickness certificates for longer periods than actually necessary varied greatly between different types of clinics, with the highest frequency among those working at: occupational medicine, orthopedic, primary health care, and psychiatry clinics; and lowest among those working in: eye, dermatology, ear/nose/throat, oncology, surgery, and infection clinics. Logistic analyses showed that sickness certifying for longer periods than necessary due to limitations in the health care system was particularly common among physicians working at occupational medicine, orthopedic, and primary health care clinics. Sickness certifying for longer periods than necessary due to patient-related factors was much more common among physicians working at psychiatric clinics. In addition to differences between clinics, frequency of sickness certificates issued for longer periods than necessary varied by age, physicians' experiences of different situations, and perceived problems.
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| 9. |
- Bränström, Richard, et al.
(author)
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Sickness certification at oncology clinics : perceived problems, support, need for education and reasons for certifying unnecessarily long sickness absences
- 2014
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In: European Journal of Cancer Care. - : John Wiley & Sons. - 0961-5423 .- 1365-2354. ; 23:1, s. 89-97
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Journal article (peer-reviewed)abstract
- Physicians' work with sickness certifications is an understudied field. The aims of this study were to gain knowledge of experiences concerning the sickness certification process among physicians working at oncology clinics. In 2008, all physicians working in Sweden (n = 36 898) were sent a questionnaire concerning sick-listing practices. All respondents working at an oncology clinic (n = 428) were included in the current study. Most of the physicians had sickness certification consultations at least weekly (91.3%). More than one fifth (22.3%) reported that they worked at a clinic with a workplace policy regarding the handling of sickness certification and 61.1% reported receiving at least some support in such cases from their immediate manager. Issuing unnecessary long sickness certificates were related to experiencing delicate interactions with patients and to lack of time. To a moderate degree, further competence was requested regarding: different types of compensation in the social insurance system, responsibilities of the Social Insurance Agency and employers, and sickness insurance rules. The large majority of physicians working in oncology reported regularly having consultations involving sickness certification. Overall, they reported few problems, low level of need for more competence regarding sickness certification, and low frequency of issuing sickness absences for longer periods than necessary.
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| 10. |
- Chen, Lingjing, et al.
(author)
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Labour market integration among young adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) at working age
- 2024
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In: Psychological Medicine. - : Cambridge University Press. - 0033-2917 .- 1469-8978. ; 54:1, s. 148-158
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Journal article (peer-reviewed)abstract
- METHODS: Multiple Swedish nationwide registers were used to identify 8045 individuals, aged 20-29, with an incident diagnosis of ADHD 2006-2011. Labour market integration was conceptualized according to the core-peripheral model as a continuum from a strong (core) to a weak (peripheral) connection to the labour market. Sequence analyses categorized clusters of labour market integration, from 1 year before to 5 years after their ADHD diagnosis for individuals diagnosed with ADHD and a matched control group without ADHD. Multinomial logistic regression computed odds ratios (ORs) with 95% confidence intervals (CIs) between sociodemographic factors and comorbid disorders and the identified clusters.RESULTS: About one-fourth of the young adults diagnosed with ADHD belonged to clusters characterized by a transition to a mainly peripheral labour market position, which was approximately four-times higher compared to controls without ADHD. Foremost, those living in small cities/villages (OR 1.9; CI 1.5-2.2), those having comorbid autism-spectrum disorder (OR 13.7; CI 6.8-27.5) or schizophrenia/psychoses (OR 7.8; CI 3.8-15.9) were associated with a transition towards a peripheral labour market position throughout the study period. Those with a high educational level (OR 0.1; CI 0.1-0.1), and men (OR 0.7; CI 0.6-0.8) were less likely to have a peripheral labour market position.CONCLUSIONS: Young adults diagnosed with ADHD are four-times more likely to be in the peripheral labour market position compared to those without ADHD. To increase labour market participation, special attention is warranted to those with low educational level, those living outside big cities and those with comorbid mental disorders.
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| 11. |
- Elrud, Rasmus, et al.
(author)
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Sickness absence among passenger car occupants following a Crash
- 2017
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In: Conference proceedings International Research Council on the Biomechanics of Injury, IRCOBI. - 2235-3151. ; 2017-September, s. 79-90
-
Conference paper (peer-reviewed)abstract
- Sickness absence is a common consequence of road traffic crashes, with high costs for the individual and society. Yet, scarcely studied, therefore, the aim was to describe sickness absence among injured car occupants. A population-based study using register data was conducted, including all car occupants of working age living in Sweden, who in 2010 had specialised in-or outpatient healthcare due to a car crash (n=9427). Individuals were categorised based on age, sex, and injury type. Odds ratios with 95% confidence intervals for a new sickness absence spell >14 days were estimated. After excluding the 9% already on sickness absence or disability pension, 10% had a new sickness absence spell >14 days. Sex and crash type were not associated with new sickness absence, while old age and being born outside Europe were associated with higher odds ratios. Odds ratios varied with the type of injury and injured body region. The odds ratio for sickness absence was highest for injuries to the spine and spinal cord odds ratio: 8.64 (95% confidence interval 6.45-11.57). Traumatic brain injuries except concussion had an odds ratio of 6.99 (4.04-12.08) while concussions had an odds ratio of 2.66 (1.80-3.93).
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| 12. |
- Ervasti, Jenni, et al.
(author)
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Contribution of comorbid conditions to the association between diabetes and disability pensions : a population-based nationwide cohort study
- 2016
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In: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health. - 0355-3140 .- 1795-990X. ; 42:3, s. 209-216
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Journal article (peer-reviewed)abstract
- OBJECTIVES: Using Swedish population-based register data, we examined the extent to which comorbid conditions contribute to the risk of disability pension among people with diabetes.METHODS: We carried out Cox proportional hazard analyses with comorbid conditions as time-dependent covariates among 14 198 people with newly diagnosed diabetes in 2006, and 39 204 people free from diabetes during the follow-up from 2007-2010. The average follow-up times were 46 and 48 months for those with and without diabetes, respectively.RESULTS: For those with diabetes only, the incidence of all-cause disability pension was 9.5 per 1000 person-years. The highest incidence of disability pension were for those with: diabetes and depression (23.6); diabetes and musculoskeletal disorder (30.6), and those with diabetes and more than one comorbid condition (36.5). The incidence rate was 5.8 for those without diabetes. Diabetes was associated with a 2.30 times [95% confidence interval (95% CI) 2.09-2.54] higher risk of disability pension (adjusted for sociodemographic factors). This association attenuated by 41% after further adjustment for comorbid chronic conditions. While diabetes was a risk factor for disability pension due to musculoskeletal disorders and diseases of the circulatory system, even after accounting for the above-mentioned conditions, the association between disability pension due to mental disorders and diabetes was diluted after adjustment for mental disorders.CONCLUSIONS: Although diabetes is an independent risk factor for disability pension, comorbid conditions contribute to this risk to a large degree.
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| 13. |
- Farrants, Kristin, et al.
(author)
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Sick leave among people in paid work after age 65 : A Swedish population-based study covering 1995, 2000, 2005 and 2010
- 2018
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In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 46:3, s. 297-305
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Journal article (peer-reviewed)abstract
- AIMS: Extending working life into older age groups is discussed in many countries. However, there is no knowledge about how this affects rates of sick leave. The aim of this work was to investigate rates of sick leave among people in paid work after retirement age and if such rates have changed over time.METHODS: Swedish nationwide register data on people aged >65 years and living in Sweden in 1995, 2000, 2005 and 2010 were analysed. All people with a sufficiently high work income to be eligible for public sick leave benefits were included. The proportions in paid work and compensated rates of sick leave for people aged 66-70 and ≥71 were analysed by sex, educational level, country of birth, living area, and employment type and sector.RESULTS: The percentage of people in paid work at ages 66-70 years increased from <10% in 1995 to 24% in 2010 and among those aged ≥71 years from 2.7% in 1995 to 3.5% in 2010. The rates of sick leave among working people aged 66-70 years were 3.3% in 1995 and 2.4% in 2010 and for people aged ≥71 years the rates of sick leave were 2.2% in 1995 and 0.2% in 2010. Women had higher rates of sick leave than men in 2005 and 2010, but lower in 1995 and 2000. In 2010, the rates of sick leave were similar between employees and the self-employed, and higher among employees in the public sector than among employees in the private sector.CONCLUSIONS: Rates of sick leave among workers aged >65 years were lower in 2010 than in 1995, despite much higher rates of labour market participation in 2010.
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| 14. |
- Farrants, Kristin, et al.
(author)
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Sick leave before and after the age of 65 years among those in paid work in Sweden in 2000 or 2005 : a register-based cohort study
- 2018
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In: Journal of international medical research. - : SAGE Publications. - 0300-0605 .- 1473-2300. ; 46:2, s. 564-577
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Journal article (peer-reviewed)abstract
- Objective With pressure for older people to remain in work, research is needed on how people aged over 65 years fare in the labour market. However, few studies have focused on sick leave among older workers, especially those over the standard retirement age. This study investigated changes in sick-leave patterns among people aged over 65 years still in work.Methods All individuals in Sweden who turned 65 years old in 2000 or 2005 were followed from 1995 to 2010. The mean number of sick-leave days per year was measured for those who remained in paid work past the age of 65 years.Results Those over 65 years still working had fewer sick-leave days before the age of 65 years than those who retired. They also had fewer sick-leave days after 65 years than before. There were fewer socioeconomic differences after 65 years than before, but these differences were greater for workers over 65 years in the 2005 cohort.Conclusions Although there were more people over 65 years in paid work in 2005, sick-leave days and socioeconomic differences in sick leave were lower in this age group. Sick-leave days and socioeconomic differences in sick leave were greater in the 2005 cohort.
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| 15. |
- Gimeno, David, et al.
(author)
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Cross-national comparisons of sickness absence systems and statistics : towards common indicators
- 2014
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In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 24:4, s. 663-666
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Journal article (peer-reviewed)abstract
- We aimed to identify common elements in work sickness absence (SA) in Spain, Sweden and The Netherlands. We estimated basic statistics on benefits eligibility, SA incidence and duration and distribution by major diagnostics. The three countries offer SA benefits for at least 12 months and wage replacement, differing in who and when the payer assumes responsibility; the national health systems provide health care with participation from occupational health services. Episodes per 1000 salaried workers and episode duration varied by country; their distribution by diagnostic was similar. Basic and useful SA indicators can be constructed to facilitate cross-country comparisons.
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| 16. |
- Gustavsson, Catharina, et al.
(author)
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Problems experienced by gynecologists/obstetricians in sickness certification consultations.
- 2013
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 92:9, s. 1007-16
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To explore frequencies and experiences with problems in sickness certification consultations among gynecologists and obstetricians in two different years.DESIGN: Cross-sectional surveys on two occasions; in 2004 and 2008.SETTING: Gynecological, obstetric and maternal health care.SAMPLE: Physicians working in gynecology, obstetrics or maternal health care in two Swedish counties from two samples: in 2004 (n = 315), and in 2008 (n = 327).METHODS: Data regarding sickness certification consultations were obtained from comprehensive questionnaires that had been mailed to the physicians in two Swedish counties in 2004 and in 2008, respectively.OUTCOME MEASURES: Frequencies and types of problems in sickness certification consultations, organizational support, and need to acquire more competence.RESULTS: The majority experienced that patients requested to be on sick leave for a reason other than work incapacity due to disease or injury, at least a few times per year (85% in 2004 and 88% in 2008). The most problematic situation to handle was when the physician and the patient had different opinions about the need for sick leave (2004: 66% and 2008: 58%). The physicians expressed a need for more competence about the options and responsibilities of employers, social insurance officers and physicians in sickness certification cases.CONCLUSIONS: Most gynecologists/obstetricians find sickness certification consultations problematic and especially when encountering patients requesting to be on sick leave for reasons other than disease. The physicians expressed a need for more competence in insurance medicine, especially about their own and other stakeholders' options and responsibilities.
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| 17. |
- Gustavsson, Catharina, et al.
(author)
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Problems experienced by gynecologists/obstetricians in sickness certification consultations
- 2013
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In: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 92:9, s. 1007-1016
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To explore frequencies and experiences with problems in sickness certification consultations among gynecologists and obstetricians in two different years.DESIGN: Cross-sectional surveys on two occasions; in 2004 and 2008.SETTING: Gynecological, obstetric and maternal health care.SAMPLE: Physicians working in gynecology, obstetrics or maternal health care in two Swedish counties from two samples: in 2004 (n = 315), and in 2008 (n = 327).METHODS: Data regarding sickness certification consultations were obtained from comprehensive questionnaires that had been mailed to the physicians in two Swedish counties in 2004 and in 2008, respectively.OUTCOME MEASURES: Frequencies and types of problems in sickness certification consultations, organizational support, and need to acquire more competence.RESULTS: The majority experienced that patients requested to be on sick leave for a reason other than work incapacity due to disease or injury, at least a few times per year (85% in 2004 and 88% in 2008). The most problematic situation to handle was when the physician and the patient had different opinions about the need for sick leave (2004: 66% and 2008: 58%). The physicians expressed a need for more competence about the options and responsibilities of employers, social insurance officers and physicians in sickness certification cases.CONCLUSIONS: Most gynecologists/obstetricians find sickness certification consultations problematic and especially when encountering patients requesting to be on sick leave for reasons other than disease. The physicians expressed a need for more competence in insurance medicine, especially about their own and other stakeholders' options and responsibilities.
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| 18. |
- Halava, Heli, et al.
(author)
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Influence of Retirement on Adherence to Statins in the Insurance Medicine All-Sweden Total Population Data Base
- 2015
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:6
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Journal article (peer-reviewed)abstract
- Background Retirement has been suggested to reduce medication adherence, but no evidence is available for statins. We investigated changes in adherence to statins among Swedish adults after retirement. Methods A prospective cohort study was carried out on all individuals living in Sweden on 31 December 2004, alive in 2010, having purchased statins in the second half of 2005, and retired in 2008 (n=11 718). We used prescription dispensing data in 2006-2010 to determine nonadherence (defined as <80% of days covered by filled prescriptions) before and after old-age or disability retirement. Using multiple repeat measurements of filled statin prescriptions, we calculated the annual prevalence rates of nonadherence for those who continued therapy. Discontinuation was defined as no statin dispensations during a calendar year. Results After adjustment for age at retirement, the prevalence ratio (PR) of nonadherence after retirement in comparison with those before retirement was 1.23 [95% confidence interval (CI) 1.17-1.29] for the men and 1.19 (95% CI 1.13-1.26) for the women. A post-retirement increase in nonadherence was consistently observed across the strata of age at retirement, marital status, education, income, type of retirement, and participants with and without cardiovascular disease, the largest increases being observed for statin use in secondary prevention (men: PR 1.38, 95% CI 1.26-1.54; women: PR 1.43, 1.18-1.72). For primary prevention, the corresponding prevalence ratios were 1.18 (95% CI 1.13. 1.25) and 1.18 (95% CI 1.11-1.24), respectively. Interpretation Retirement appears to be associated with increased nonadherence to statin therapy among Swedish men and women.
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| 19. |
- Halava, Heli, et al.
(author)
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Influence of Retirement on Adherence to Statins in the Insurance Medicine All-Sweden Total Population Data Base
- 2015
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:6
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Journal article (peer-reviewed)abstract
- BACKGROUND: Retirement has been suggested to reduce medication adherence, but no evidence is available for statins. We investigated changes in adherence to statins among Swedish adults after retirement.METHODS: A prospective cohort study was carried out on all individuals living in Sweden on 31 December 2004, alive in 2010, having purchased statins in the second half of 2005, and retired in 2008 (n=11 718). We used prescription dispensing data in 2006-2010 to determine nonadherence (defined as <80% of days covered by filled prescriptions) before and after old-age or disability retirement. Using multiple repeat measurements of filled statin prescriptions, we calculated the annual prevalence rates of nonadherence for those who continued therapy. Discontinuation was defined as no statin dispensations during a calendar year.RESULTS: After adjustment for age at retirement, the prevalence ratio (PR) of nonadherence after retirement in comparison with those before retirement was 1.23 [95% confidence interval (CI) 1.17-1.29] for the men and 1.19 (95% CI 1.13-1.26) for the women. A post-retirement increase in nonadherence was consistently observed across the strata of age at retirement, marital status, education, income, type of retirement, and participants with and without cardiovascular disease, the largest increases being observed for statin use in secondary prevention (men: PR 1.38, 95% CI 1.26-1.54; women: PR 1.43, 1.18-1.72). For primary prevention, the corresponding prevalence ratios were 1.18 (95% CI 1.13‒1.25) and 1.18 (95% CI 1.11-1.24), respectively.INTERPRETATION: Retirement appears to be associated with increased nonadherence to statin therapy among Swedish men and women.
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| 20. |
- Jonsson, Ulf, 1974-, et al.
(author)
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Diagnosis-specific disability pension predicts suicidal behaviour and mortality in young adults : a nationwide prospective cohort study
- 2013
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In: BMJ Open. - : BMJ. - 2044-6055. ; 3:2
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Journal article (peer-reviewed)abstract
- Objectives: Increasing rates of disability pension (DP), particularly owing to mental diagnoses, have been observed among young adults in Organisation for Economic Co-operation and Development (OECD) countries. There is a lack of knowledge about the health prognosis in this group. The aim of this study was to investigate whether DP in young adulthood owing to specific mental diagnoses or somatic diagnoses predicts suicidal behaviour and all-cause mortality.Design: A nationwide prospective cohort study.Setting: A register study of all young adults who in 2005 were 19-23 years old and lived in Sweden. Registers held by the National Board of Health and Welfare, Statistics Sweden and the National Social Insurance Agency were used.Participants: 525 276 young adults. Those who in 2005 had DP with mental diagnoses (n=8070) or somatic diagnoses (n=3975) were compared to all the other young adults in the same age group (n=513 231).Outcome measures: HRs for suicide attempt, suicide and all-cause mortality in 2006-2010 were calculated by Cox proportionate hazard regression models, adjusted for sex, country of birth, parental education and parental and previous own suicidal behaviour.Results: The adjusted HR for suicide attempt was 3.32 (95% CI 2.98 to 3.69) among those on DP with mental diagnoses and 1.78 (95% CI 1.41 to 2.26) among those on DP with somatic diagnoses. For the specific mental diagnoses, the unadjusted HRs ranged between 2.42 (mental retardation) and 22.94 (personality disorders), while the adjusted HRs ranged between 2.03 (mental retardation) and 6.00 (bipolar disorder). There was an increased risk of mortality for young adults on DP in general, but only those with mental DP diagnoses had a significantly elevated HR of completed suicide with an adjusted HR of 3.92 (95% CI 2.83 to 5.43).Conclusions: Young adults on DP are at increased risk of suicidal behaviour and preterm death, which emphasises the need for improved treatment and follow-up.
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| 21. |
- Jonsson, Ulf, 1974-, et al.
(author)
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Psychiatric diagnoses and risk of suicidal behaviour in young disability pensioners : prospective cohort studies of all 19-23 year olds in Sweden in 1995, 2000, and 2005, respectively.
- 2014
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:11
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Increasing rates of disability pension (DP) have been observed among young adults. We studied specific psychiatric DP diagnoses and subsequent risk of suicidal behaviour in a series of three cohorts of young adult in Sweden.METHOD: In a nationwide register study, we included all young adults who in 1995, 2000, and 2005, respectively, were 19-23 years old and lived in Sweden (n≈500,000 per cohort). Rates of DP and specific psychiatric DP diagnoses were recorded in each cohort. Hazard ratios (HRs) and 95% confidence intervals (CIs) for suicidal behaviour during the following five years, with the corresponding age group as reference, were calculated by Cox proportional hazard regression, adjusted for demographic variables and previous own and parental suicidal behaviour.RESULTS: The overall proportion with DP in this age group increased from 0.92% in 1995 to 2.29% in 2005, with particularly large increases in psychiatric diagnoses such as hyperkinetic disorders, pervasive developmental disorders, and depression/anxiety. The overall proportion of young disability pensioners attempting suicide during the five-year follow-up increased from 2.21% in the 1995 cohort to 3.81% in the 2005 cohort. Within most psychiatric DP diagnoses, the risk of attempted suicide did not change significantly over time, whereas suicide attempts increased in the reference group. Accordingly, the HRs for suicide attempt decreased in some psychiatric DP diagnoses. The highest adjusted HRs were observed for depression/anxiety (16.41; CI: 9.06 to 29.74) and schizophrenia (9.37; 6.13 to 14.31) in the 1995 cohort. The rate of suicide among young disability pensioners during follow-up ranged from 0.19% in 1995 to 0.37% in 2005, mainly occurring in individuals with psychiatric diagnoses.CONCLUSION: Suicidal behaviour has become more prevalent among young disability pensioners, which co-occurred with an increased tendency to grant DP in psychiatric diagnoses with a known high risk of suicidal behaviour. Preventive measures are warranted.
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| 22. |
- Jonsson, Ulf, 1974-, et al.
(author)
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Psychiatric diagnoses and risk of suicidal behaviour in young disability pensioners : prospective cohort studies of all 19-23 year olds in Sweden in 1995, 2000, and 2005, respectively
- 2014
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:11
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: Increasing rates of disability pension (DP) have been observed among young adults. We studied specific psychiatric DP diagnoses and subsequent risk of suicidal behaviour in a series of three cohorts of young adult in Sweden.METHOD: In a nationwide register study, we included all young adults who in 1995, 2000, and 2005, respectively, were 19-23 years old and lived in Sweden (n≈500,000 per cohort). Rates of DP and specific psychiatric DP diagnoses were recorded in each cohort. Hazard ratios (HRs) and 95% confidence intervals (CIs) for suicidal behaviour during the following five years, with the corresponding age group as reference, were calculated by Cox proportional hazard regression, adjusted for demographic variables and previous own and parental suicidal behaviour.RESULTS: The overall proportion with DP in this age group increased from 0.92% in 1995 to 2.29% in 2005, with particularly large increases in psychiatric diagnoses such as hyperkinetic disorders, pervasive developmental disorders, and depression/anxiety. The overall proportion of young disability pensioners attempting suicide during the five-year follow-up increased from 2.21% in the 1995 cohort to 3.81% in the 2005 cohort. Within most psychiatric DP diagnoses, the risk of attempted suicide did not change significantly over time, whereas suicide attempts increased in the reference group. Accordingly, the HRs for suicide attempt decreased in some psychiatric DP diagnoses. The highest adjusted HRs were observed for depression/anxiety (16.41; CI: 9.06 to 29.74) and schizophrenia (9.37; 6.13 to 14.31) in the 1995 cohort. The rate of suicide among young disability pensioners during follow-up ranged from 0.19% in 1995 to 0.37% in 2005, mainly occurring in individuals with psychiatric diagnoses.
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| 23. |
- Kjeldgård, Linnea, 1985-, et al.
(author)
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Bicycle crashes and sickness absence - a population-based Swedish register study of all individuals of working ages
- 2019
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In: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Journal article (peer-reviewed)abstract
- BackgroundIn recent years, bicycle injuries have increased, yet little is known about the impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore SA and DP among individuals of working ages injured in a bicycle crash.MethodA nationwide register-based study, including all individuals aged 16-64years and living in Sweden, who in 2010 had in- or specialized out-patient healthcare (including emergency units) after a bicycle crash. Information on age, sex, sociodemographics, SA, DP, crash type, injury type, and injured body region was used. We analyzed individuals with no SA or DP, with ongoing SA or full-time DP already at the time of the crash, and with new SA >14days in connection to the crash. Crude and adjusted odds ratios (OR) with 95% confidence intervals for new SA were estimated by logistic regression.ResultsIn total, 7643 individuals had healthcare due to a new bicycle crash (of which 85% were single-bicycle crashes). Among all, 10% were already on SA or full-time DP at the time of the crash, while 18% had a new SA spell. The most common types of injuries were external injuries (38%) and fractures (37%). The body region most frequently injured was the upper extremities (43%). Women had higher OR (1.40; 1.23-1.58) for new SA than men, as did older individuals compared with younger (OR 2.50; 2.02-3.09, for ages: 55-64 vs. 25-34). The injury types with the highest ORs for new SA, compared with the reference group external injuries was fractures (8.04; 6.62-9.77) and internal injuries (7.34; 3.67-14.66). Individuals with traumatic brain injury and injuries to the vertebral column and spinal cord had higher ORs for SA compared with other head, face, and neck injuries (2.72; 1.19-6.22 and 3.53; 2.24-5.55, respectively).ConclusionsIn this explorative nationwide study of new bicycle crashes among individuals of working ages, 18% had a new SA spell in connection to the crash while 10% were already on SA or DP. The ORs for new SA were higher among women, older individuals, and among individuals with a fracture.
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| 24. |
- Kjeldgård, Linnea, 1985-, et al.
(author)
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Diagnosis-specific sickness absence among injured working-aged pedestrians: a sequence analysis
- 2023
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 23:1, s. 367-
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Journal article (peer-reviewed)abstract
- BACKGROUND: The knowledge about the long-term consequences in terms of sickness absence (SA) among pedestrians injured in a traffic-related accident, including falls, is scarce. Therefore, the aim was to explore diagnosis-specific patterns of SA during a four-year period and their association with different sociodemographic and occupational factors among all individuals of working ages who were injured as a pedestrian. METHODS: A nationwide register-based study, including all individuals aged 20-59 and living in Sweden, who in 2014-2016 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Diagnosis-specific SA (> 14 days) was assessed weekly from one year before the accident up until three years after the accident. Sequence analysis was used to identify patterns (sequences) of SA, and cluster analysis to form clusters of individuals with similar sequences. Odds ratios (ORs) with 95% confidence intervals (CIs) for association of the different factors and cluster memberships were estimated by multinomial logistic regression. RESULTS: In total, 11,432 pedestrians received healthcare due to a traffic-related accident. Eight clusters of SA patterns were identified. The largest cluster was characterized by no SA, three clusters had different SA patterns due to injury diagnoses (immediate, episodic, and later). One cluster had SA both due to injury and other diagnoses. Two clusters had SA due to other diagnoses (short-term and long-term) and one cluster mainly consisted of individuals with disability pension (DP). Compared to the cluster "No SA", all other clusters were associated with older age, no university education, having been hospitalized, and working in health and social care. The clusters "Immediate SA", "Episodic SA" and "Both SA due to injury and other diagnoses" were also associated with higher odds of pedestrians who sustained a fracture. CONCLUSIONS: This nationwide study of the working-aged pedestrians observed diverging patterns of SA after their accident. The largest cluster of pedestrians had no SA, and the other seven clusters had different patterns of SA in terms of diagnosis (injury and other diagnoses) and timing of SA. Differences were found between all clusters regarding sociodemographic and occupational factors. This information can contribute to the understanding of long-term consequences of road traffic accidents.
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| 25. |
- Kjeldgård, Linnea, 1985-, et al.
(author)
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Sequence analysis of sickness absence and disability pension in the year before and the three years following a bicycle crash; a nationwide longitudinal cohort study of 6353 injured individuals
- 2020
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
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Journal article (peer-reviewed)abstract
- Background: Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries. Aims: To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods: A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results: Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor vehicles (1.9;1.1–3.2) and traumatic brain injury, not concussion (18.4;2.2–155.2). Conclusion: Sequence analysis enabled exploration of the large heterogeneity of SA and DP following a bicycle crash. More knowledge is needed on how to prevent bicycle crashes and especially those crashes/injuries leading to long-term consequences.
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