Determinantes de la duración de la incapacidad temporal y la vuelta al trabajo en un área sanitaria de Galicia

Abstract

To determine the factors associated with the incidence and duration of temporary work incapacity (TWI) in a health district. Descriptive and retrospective study. South health district of the province of Lugo, Spain. A random sample of 1513 cases was selected among the total of episodes of TWI, during 3 years period. The main factors analyzed are, on the one hand, the socio-demographic characteristics of the patient, his or her social security (SS) scheme, diagnosis that justifies the TWD, and the prescription date; and, on the other hand, the age, sex, specialised training, time in the post and years in practice of the physician who prescribes the TWI. The comparison of the means was carried out using variance analysis and the Kruskal-Wallis test. The relative effect of each variable on the probability of returning to the work was estimated through Cox regression models. The mean duration of the episodes of TWI was of 74+/-103 days. The most frequent diagnoses were those of the bones-muscles and joints (BMAJ), injuries and poisonings (IAP), and respiratory diseases (RD). The probability of returning to work is reduced with the increase of the age, with agrarian and autonomous SS affiliates, with diagnoses of mental disease or diagnoses of the circulatory system, and in cases prescribed by older doctors or less time in the post. The mean duration of the episodes of TWD is higher than that of other Spanish studies. The most influential factors in the return to work are the age of the patient, the SS scheme and the diagnosed illness.