Abstract
PurposeAlternative duty work is a procedure that enables an employee with a short-term disability to perform modified duties as an alternative to sickness absence. We examined whether the implementation of an alternative duty policy was associated with reduced sickness absence in the Finnish public sector.MethodsTwo city administrations (A and D) that implemented an alternative duty work policy to their employees (n = 5341 and n = 7538) served as our intervention cities, and two city administrations (B and C) that did not implement the policy represented the reference cities (n = 6976 and n = 6720). The outcomes were the number of annual days, all episodes, and short-term (< 10 days) episodes during the 2 years before versus the 2 years after the intervention year. We applied repeated measures negative binomial regression analyses, using the generalized estimating equations method and the difference-in-difference analysis to compare the intervention and control cities (adjusted for sex, age, type of job contract, occupational class).ResultsDuring the five-year study period, the number of sickness absence days and episodes increased in both the intervention and control cities. Covariate-adjusted analysis of relative risk showed that the overall increase in post- versus pre-intervention sickness absence days was smaller in intervention City A, RR = 1.14 (95% CI = 1.09–1.21) than in control cities B and C, RR = 1.19 (95% CI =1.14–1.24), group × time interaction p < 0.02. In intervention City D, we found a corresponding result regarding all sickness absence episodes and short-term sickness absence episodes but not days.ConclusionsThis follow-up suggests that implementing an alternative duty work policy may marginally decrease employees’ sickness absences.
Highlights
Sickness absence (SA) is one of the major contributors to costs arising from work disability [1]
Longitudinal studies have found part-time SA to be associated with a smaller decline in labour market participation than full-time SA [15,16,17,18,19] and the practice of reporting prolonged SA cases to occupational health services (OHS) has been linked to increased rates of continuing to work despite illness [20]
Panels D, E, and F show the respective trends in intervention city D in comparison to controls
Summary
Sickness absence (SA) is one of the major contributors to costs arising from work disability [1]. Prolonged SA is linked to a higher risk of disability pension [2,3,4] and unfavourable prognosis of return to work [5, 6]. Such SA may contribute to poorer professional efficacy and Mattila-Holappa et al BMC Public Health (2021) 21:1154 the onset of illness, disability, or handicap may not necessarily lead to work disability [11]. A recent study of public sector employees showed that the use of ‘return-to-work’ coordinators, while increasing SA, significantly reduced disability retirement [21]
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