Labor market outcomes before and after first episode of part-time sickness absence

Abstract

Abstract Background Previous research suggests that part-time sickness absence (PTSA) results in better work participation compared to full-time sickness absence (FTSA), but few studies have examined trends in FTSA and unemployment before and after PTSA. Methods This Finnish population-based cohort study included 3406 individuals with first episode (>30 days) of PTSA in 2011 (=PTSA group), 42 510 individuals with FTSA (>30 days) in 2011 (=FTSA group), and 25 167 individuals with no sickness absence (>30 days) in 2011 from the general working-age population. Annual days of FTSA from 2007 to 2015 and unemployment from 2012 to 2015 were measured for the participants of each group. We modeled trends and relative risks for these labor market outcomes using negative binomial regression with generalized estimation equations. Results For the PTSA group, the adjusted mean annual number of FTSA days was 3 in the beginning of the follow-up, 15 a year before the index year, and 8-10 after the index year. The adjusted risk ratio (RR) of FTSA days after versus before PTSA was 1.95 (95% CI 1.75-2.17). For the FTSA group, mean of sickness absence days was 4 in the beginning, 13 a year before the index year and 9-19 after the index year. The mean of FTSA was 1-2 throughout the follow-up in the general population. An increasing slope in unemployment after the index year was observed in all groups, the absolute level of unemployment being highest among FTSA group and lowest among the general population group. Conclusions Long-term PTSA marks a decline in labour market participation. In absolute terms this decline is smaller than that in employees with long-term FTSA. Key messages Part-time sickness absence lasting >30 days marked an increase in full-time sickness absence although the absence levels did not reach those observed after full-time sickness absence of > 30 days. Our results show smaller impairment in labour market outcomes in employees granted a long-term part-time sickness absence than in those with long-term full-time sickness absence.