Maite Sampere

Incapacidad temporal por contingencia común: papel de la edad, el sexo, la actividad económica y la Comunidad Autónoma

Fundamentos: Describir la duracion de episodios incidentes de incapacidad temporal por contingencias comunes segun la edad, el sexo, la actividad economica y la Comunidad Autonoma. Metodos: Incluimos 76.598 episodios de incapacidad temporal iniciados en 2002 en trabajadores afiliados al Regimen General de la Seguridad Social y gestionados por una Mutua de Accidentes de Trabajo y Enfermedad Profesional. La duracion mediana y el rango intercuartilico fue estimada por sexo, edad, actividad economica y Comunidad Autonoma. La razon de probabilidad de seguir de baja (RPSB) entre Comunidades Autonomas se ajusto por sexo, edad y actividad economica, tomando Navarra como referencia, mediante un modelo de regresion log-logistica con fragilidad gamma compartida. Resultados: El 25% de los sujetos habian vuelto al trabajo al 4o dia, el 50% al 9o dia y el 75% al 26o dia. Extremadura (RPSB=2,7; IC95%:2,4 a 3,1) y Galicia (2,6; 2,4 a 2,9) presentaron las diferencias mas elevadas respecto a Navarra. Conclusiones: La reincorporacion al trabajo despues de un episodio de incapacidad temporal es un proceso complejo que esta influido, ademas de por la edad y el sexo, por la actividad economica y la Comunidad Autonoma.

Organizational return to work support and sick leave duration: a cohort of Spanish workers with a long-term non-work-related sick leave episode.

Objective: To analyze the association between organizational support and time to return to work (RTW) in workers with long-term non–work-related sick leave. Methods: Cohort participants were 571 workers, with a non–work-related sick leave episode of more than 15 days, recruited during the first visit in a health insurance company (mutua). Workers completed a baseline questionnaire regarding organizational RTW support measures and were followed until the end of the episodes. Return to work and time to RTW were established on the basis of the mutuas register. Multivariate Cox regression models were used. Results: Workers in companies with an overall high organizational RTW support returned to work earlier. This effect was mainly due to workers in companies that provided specific RTW programs. Conclusions: Our findings suggest that companies play an important role in facilitating RTW for workers with long-term non–work-related sick leave episodes.

Effect of working conditions on non-work-related sickness absence

BACKGROUND There is limited evidence of the role of working conditions as prognostic factors for non-work-related sickness absence (i.e. absence due to injuries or diseases of non-occupational origin). AIMS To analyse the association between working conditions and time to return to work (RTW) in workers with long-term (>15 days) non-work-related sickness absence. METHODS We followed up a total of 655 workers, who completed a baseline questionnaire including physical and psychosocial work factors, until their non-work-related long-term sickness absence ended. Time to RTW was determined based on the health insurance company register. Cox proportional hazard models were constructed to evaluate the associations between working conditions and time to RTW. RESULTS A self-perceived high level of physical activity at work and work with back twisted or bent were related to longer duration of sickness absence. We did not find any strong evidence of associations between psychosocial work factors and time to RTW, although higher job insecurity and low reward showed marginal statistical significance. CONCLUSIONS Hazardous physical working conditions are associated with longer duration of non-work-related sickness absence. Workplace ergonomic interventions could conceivably shorten the length of sickness absence that has not originated at work.

Does return to work occur earlier after work-related sick leave episodes than after non-work-related sick leave episodes? A retrospective cohort study in Spain

Objective: In Spain, sick pay benefits for work-related sick leave episodes are higher than for non-work-related episodes. Our aim is to assess whether time to return to work is longer for higher paid sick leave episodes than for lower paid episodes. Methods: We used data from 62 376 work-related and 76 932 non-work-related sick leave episodes occurring among 338 226 workers from 56 099 companies in Spain in 2002. All episodes were followed for up to 18 months. Episodes were classified by a physician as being work- or non-work-related according to medico-legal judgments. The median episode duration and the 25th and 75th percentiles were calculated. The probability of remaining absent from work was estimated by a non-parametric estimator of the marginal survival function. The time ratio between both types of sick leave was estimated by a log-logistic regression model, using non-work-related episodes as the reference. Results: Median episode duration (25th–75th percentiles) was 11 (6–21) days for work-related episodes and 9 (4–29) days for non-work-related episodes. Time to return to work was longer for work-related episodes than for non-work-related episodes of less than 16 days (time ratio: 1.19 in men and 1.08 in women), while the opposite was observed for episodes of more than 15 days (0.58 in men and 0.40 in women). Conclusions: Sick pay benefits have a limited effect on time to return to work after a sick leave episode.

Relación entre las tasas de desempleo y los indicadores de absentismo por incapacidad temporal durante periodos de crisis económica

espanolIntroduccion: Estudios realizados en varios paises presentan una relacion inversa entre las tasas de desempleo (TD) y los indicadores de absentismo por incapacidad temporal (IT) durante periodos de crisis economica. Objetivo: Evaluar la relacion entre indicadores de absentismo y el desempleo en Espana (2009-2015). Metodos: Se obtuvieron tasas de incidencia (TI) y absentismo (TA) por IT de origen comun (ITcc) a partir de datos de la Seguridad Social, asi como las TD segun datos del Instituto Nacional de Estadistica. Se describio graficamente la evolucion temporal de los indicadores de ITcc y el desempleo en el periodo 2009-2015. Para explorar dicha relacion tambien se realizaron graficos de dispersion de los indicadores frente a las TD. Posteriormente, se ajustaron modelos de regresion lineal simple. Resultados: Las TI y TA descienden en 2009-2013 (TI 2009=28,07%, TI 2013=20,41%, TA 2009=2,53%, TA 2013=1,86%) momento en que cambia su tendencia, iniciando una fase ascendente hasta 2015 (TI 2015=22,52%, TA 2015=2,12%). La TD asciende en 2009-2013 (TD 2009=17,86%, TD 2013=26,10%), pasando a descender hasta 2015 (TD 2015=22,06%). Las TD y los indicadores de absentismo presentan una relacion lineal inversa. Conclusiones: Se observo una relacion inversa entre el desempleo y los indicadores de absentismo en Espana. Son necesarios estudios especificos para poder evaluar hipotesis explicativas como las asociadas a los efectos de disciplina, seleccion y/o cambios en la fuerza de trabajo. EnglishIntroduction: Different countries have shown an inverse relationship between unemployment rates (UR) and indicators of sickness absence during periods of economic recession. Objective: To evaluate the relationship between indicators of sickness absence and unemployment in Spain during 2009-2015. Methods: We obtained incidence and absenteeism rates of non-work related sickness absence (NWSA) from Social Security data, and UR from the National Institute of Statistics. The relationship between indicators of NWSA and UR in the period 2009 to 2015 was graphically described using time trend plots. Scatter plots of NWSA indicators were also made against UR. Finally, we fitted linear regression models. Results: Incidence (IR) and absenteeism rates (AR) of NWSA showed downward trends in 2009-2013 (IR 2009=28.07%, IR 2013=20.41%; AR 2009=2.53% and AR 2013=1.86%), changing to an upward trend up to 2015 (IR 2015=22.52%, AR 2015=2.12%). Unemployment rates trended upward in 2009-2013 (UR 2009=17.86%, UR 2013=26.10%), and then changed to a downward trend through 2015 (UR 2015=22.06%). There was an inverse relationship between UR and NWSA indicators. Conclusions: As in previous international studies, we found an inverse relationship between unemployment rates and indicators of sickness absence in Spain. More detailed studies are needed to evaluate explanatory hypotheses, such as those associated with the effects of discipline, selection and/or changes in the workforce.

P324 Segmentation of sick leave episodes according to their duration as a strategy for analysis

Background Short and long term sickness absence (SA) are due to different causes, therefore require different approaches to intervention. In research on SA, incidence had usually been analysed separately from the duration of episodes. Objective Describe the usefulness of the analysis of SA incidence by segmentation of duration of episodes versus non-segmented analysis. Methods We compared overall incidence of non-work related SA and incidence of SA segmented by duration (short duration (≤ 15 days), medium (16–30, 31–90) and long (> 90)). We used data from a health insurance company (“mutua”) in Spain during 2011 (230,332 episodes, 752,906 workers). The incidence rate was calculated according to age groups (<25, 25–34, 35–44, 45–54, ≥55). We computed rate ratios, with their 95% confidence interval (95% CI), to quantify linear trend (RR-T) and association (RR) of SA between age groups. Results The overall incidence of SA showed a steady decline with age (RR-T = 0.92, 95% CI = 0.91–0.92) with an incidence of 36.4% in <25 years versus 29.3% in ≥55 years (RR = 1.24, 95% CI = 1.22–1.27). The overall excess incidence observed in young is produced by short duration (RR-T = 0.82, 95% CI = 0.82–0 82; RR = 1.98, 95% CI = 1.93–2.03). In addition, the incidence of long term SA changed this pattern (RR-T = 1.32, 95% CI = 1.30–1.33), being more frequent in ≥55 years relative to the youngest (5.5% versus 2.1%, RTI = 3.19, 95% CI = 2.97–3.43). Conclusions The analysis of indicators of SA segmented by duration of episodes provides more precise image than that obtained from global data. Information on the type of episodes of IT according to duration provides valuable information for SA intervention.

P325 The evolution of the incidence of sick leave episodes according to their duration

Background One way used to measure the absenteeism is the analysis of incidence of non-work related sickness absence (NWSA). Study of incidence by segments duration and its evolution allow identifying typology of incidence of NWSA, being useful in the sickness absence management. Objective Describe evolution of incidence of NWSA by segments duration between 2009 and 2015 in Spain. Methods We computed the overall incidence of NWSA and by segments duration. The data used for this study comes from a health insurance company in Spain from 2009 to 2015. The analysis was stratified by age (18–24, 25–34, 35–44, 45–54 and 55–64 years) and sex. Segments were defined by periods (days) short (≤15), medium (16–30, 31–90) and long (>90) term. The Annual Percentage Change (APC) was calculated using the Poisson Model with an inflection point in 2013. Results The overall evolution of incidence of NWSA showed a decreasing trend in 2009–2013 (APC −8%, 95% CI: −12%; − 5%), and an increasing in 2013–2015 (APC 5%, 95% CI: −3%; 13%). The drop of the APC had similar incidence of NWSA in all duration segments being the short processes the ones with a major contribution. Incidence of NWSA (overall and segments) presented an APC more pronounced in workers under 25 years. In 2009 the incidence of short processes in younger workers were 2.4 times higher than in older, while from 2013 to 2015, this difference was reduced to 1.5. In both sexes, the evolution of INWSA was similar, with higher values in women. Conclusions Changes in the evolution of incidence of NWSA occurred in all segments of duration, being the short duration segments those with more influence. The declension was more noticeable in younger workers. The ascension showed that the differences by age decreased as a result of the short duration processes.

P323 Relationship between sickness absence and unemployment in spain (2009-2014)

Background Different countries have shown an inverse relationship between unemployment rates and indicators of sickness absence during periods of economic recession. To our knowledge there is no study which has investigated the relationship between unemployment and absenteeism in Spain. Objectives Evaluate the relationship between indicators of absenteeism and unemployment in Spain during 2009-2014. Methods We obtained incidence (IR) and absenteeism rates (AR) of non-work related sickness absence (NWSA). Data was obtained from the population protected by a health insurance company (“mutua”) collected by the Social Security. Data on unemployment rates (UR) was provided by the National Statistics Institute in Spain. The relationship between indicators of NWSA and unemployment in the period 2009 to 2014 was graphically described using time trend plots. Scatter plots of NWSA indicators were also made against unemployment. Finally, we fitted statistical regression models using absenteeism indicators as dependent variables and unemployment rates as an explanatory variable. Results Incidence and absenteeism rates of NWSA showed downward trends in 2009–2014 (IR 2009 = 28.1% and IR 2014 = 20.8%; AR 2009 = 2.5% and AR 2014 = 2.0%). On the other hand, the unemployment rate had an upward trend in the study period (UR 2009 = 17.9% and UR 2014 = 24.4%). An inverse relationship between unemployment rates and absenteeism indicators was observed (incidence rates: Beta unemployment = −0.93 (p < 0.01) and R-Squared = 95.2%; absenteeism rates: Beta unemployment = −0.08 (p < 0.01) and R-Squared = 99.0%). Conclusions As in previous international studies, an inverse relationship between unemployment and absenteeism was observed in Spain. Specific studies are needed to evaluate explanatory hypotheses such as those associated with the theory of discipline and changes in the workforce.