Longer Sickness Research Articles

Comparison of intubation and tracheotomy in adult patients with acute epiglottitis or supraglottitis

PurposeIn acute epiglottitis (AE) or acute supraglottitis (AS), the management of the airway is crucial. We hypothesized that tracheotomized patients recover faster than intubated patients do.MethodsWe retrospectively reviewed all adult AE and AS patients, who underwent intubation or tracheotomy between 2007 and 2018 in a tertiary care center. Patient demographics, treatment, and complications were analyzed.ResultsThe cohort comprised 42 patients. The airway was secured with intubation in 50% and with tracheotomy in 50%. All intubated patients (n = 21) and three tracheotomized patients were treated in the intensive care unit (p < 0.0001). Procedure-related complications were encountered in three intubated and eight tracheotomized patients (p = 0.892). Median overall treatment cost was 11.547 € and 5.856 € in the intubated and tracheotomized patient groups, respectively (p < 0.001). The median duration of sick leave after discharge from hospital was 13 days in the tracheotomy group and 7 days in the intubation group (p = 0.097).ConclusionTracheotomy resulted in a less expensive management in securing the airway in AE or AS, but tracheotomized patients had a trend towards more complications and longer sick leaves compared to intubated patients.Level of evidence2b

Short sickness absence and subsequent sickness absence due to mental disorders - a follow-up study among municipal employees

BackgroundMental disorders are common diagnostic causes for longer sickness absence and disability retirement in OECD-countries. Short sickness absence spells are also common, and neither trivial for health and work ability. We studied how prior short sickness absence spells and days are associated with subsequent longer sickness absence due to mental disorders in two age-groups of municipal employees during a 2-, 5- and 9-year follow-up.MethodsThe analyses covered 20–34 and 35–49-year-old employees of the City of Helsinki in 2004. Those with prior ≥14 day sickness absence in 2002, 2003 or 2004 were excluded. Women and men were pooled together. Short, 1–13-day sickness absence spells and days were calculated per the actual time of employment during 2004. Logistic regression analysis was used to calculate odds ratios (OR) and their 95% confidence intervals (CI) for the subsequent long (≥14 days) sickness absence due to mental disorders during three follow-ups.ResultsThe risk for long sickness absence due to mental disorders increased with increasing amount of short sickness absence spells and days. 3 or more short sickness absence spells and 8–14 sickness absence days from short spells in 2004 were strongly associated with subsequent long sickness absence in all three follow-ups. The associations were strongest for the 2-year follow-up; the younger employees tended to have higher risks than the older ones.ConclusionsThree spells or 8 days of short sickness absence per year constitutes a high risk for subsequent long sickness absence due to mental disorders and preventive measures should be considered.

Short sickness absence spells and long mental sickness absence in 10-year follow-up

Background Mental disorders are common diagnostic causes for longer sickness absence and disability retirement in OECD-countries. Short sickness absence spells are also common, and neither trivial for health and work ability. We studied how prior short sickness absence spells and days are associated with subsequent longer sickness absence due to mental disorders in three age-groups of …

Pathways of reorganization, leadership and long-term sickness absence due to mental diagnosis among local government public sector employees in Sweden 1998-2012

The aim is to study local variation in long-term sickness absence due to mental diagnosis among local government public sector employees during a fifteen year period (1998-2012) and its relation to reported larger reorganizations of local government public services in the periods of 2000-2004, 2006-2008 and 2010-2012. Longitudinal cluster analysis of ecological data is performed on the incidence of 90 days or longer sickness absence including new disability pensions each year between 1998 and 2012, generating clusters of municipalities with lower and higher incidence of sickness absence across the period studied. Aggregate data from surveys performed in 2004, 2008 and 2012 with the leading political, administrative and union representatives in all of the 290 municipal level local governments in Sweden on organizational change are used in logistic regression analysis to elucidate whether there are significant effects of different types of organizational change and leadership during the reorganization on mental sickness rates across time. The analysis is performed with control for organizational complexity of larger cities (residential cities and those with over 50.000 inhabitants), population size generally, and municipality unemployment levels. The results indicate statistically significant effects of both organizational changes reported 2004, 2008 and 2012, as well as leadership reported in 2012, on top of the impact of large scale organizational complexity. Large scale organizational complexity, as well as general organizational change pressure and mandatory management of work place meetings all tend to increase the probability for long-term sickness absence due to mental diagnosis. In contrast, organizational change guided by specific characteristics with regard to implementation within an organizational field (social care in 2008), as well as specific leadership by targeted manager-employee communication, tends to significantly reduce long-term sickness absence. These findings suggest two alternative pathways of reducing mental stress leading to long-term sickness absence for local governments during large scale reorganization: implementation within an organizational field, and managerial work-place policies based on personalized leadership communication.

No longer sick: what does it convey? An empirical analysis of post‐bankruptcy performance

Purpose – The purpose of this paper is to empirically investigate the stock return and operating performance of the firms which emerged from bankruptcy during 1992‐2006 in India.Design/methodology/approach – The paper uses single factor model and matching firm approach to assess the stock return performance. It employs the level as well as change expectation models to examine the operating performance.Findings – The paper shows that the sample firms, after emerging from bankruptcy, report declining stock return as well as operating performance.Practical implications – Findings of the study raise doubts over the efficiency of Indian corporate bankruptcy reorganizing mechanism.Originality/value – Apparently, no previous study examined the post‐bankruptcy performance of the firms, particularly in the context of emerging markets, which are plagued with the principal agent problems aggravated by owner managers. Given the potential vulnerability of the bankruptcy process for the inefficient wealth transfers amo...

Termination of sickness benefits or transition to disability pension after changes in sickness insurance: a Swedish register study

Purpose: To assess whether the changes in Swedish sickness insurance in 2008 were associated with termination of benefits (TOB) or transition to disability pension (DP) for individuals in compensated sick leave of varying duration. Changes were (1) introduction of sick-listing guidelines and (2) stricter criteria for eligibility to disability pension and sickness cash benefit and time limits for the latter. Methods: The study population consisted of 2 556 211 cases of compensated sick leave with onset during 2006–2010 from the Swedish national social insurance registers. TOB and DP were analysed with Cox-proportional hazard regression. Results: After the introduction of sick-listing guidelines, TOB increased for both women [hazard ratio (HR) 1.10] and men (HR 1.07). The additional introduction of stricter rules 4 months later were modestly associated with TOB (HR: women 1.01, men 0.99) and transition to DP among men decreased with stronger associations for spells exceeding 180 days (HR 0.86). For women transition to DP surprisingly increased with stricter criteria (HR 1.09), although this pattern was reversed in sick leave spells exceeding 1 year (HR 0.90). Conclusions: Introducing sick-listing guidelines for different illnesses and diseases could have had a considerable impact on TOB. The additional introduction of stricter eligibility rules and time limits seem to have contributed less to TOB but clearly reduced DP in longer sickness spells.Implications for RehabilitationSick-listing guidelines could be a supportive tool for doctors and sickness insurance administrators in the sick-listing process and reduce unnecessary prolongation of sick leave.Specific time limits in sickness insurance and stricter eligibility rules for disability pensions have an impact on compensated sick leave and the welfare of individuals. This has to be considered in the vocational rehabilitation process in order to enhance sustainable return to work.Changes in sickness insurance could influence the duration and exit from compensated sick leave and such changes needs to be considered in studies of vocational rehabilitation, return to work and disability pension.

Correlating the Anatomical Site of Injury and Work-Related Factors With Sick Leave Duration Following Minor Musculoskeletal Injuries

ABSTRACT Many factors are associated with long sick leaves and therefore, reliance solely on disease-related factors can potentially underestimate sick leave durations. Here, we wanted to assess the association between the injury sites, work-related factors, and the length of sick leaves. Comprehensive medical legal reports of workers with pure minor musculoskeletal injuries were reviewed. 2029 reports of workers were included. 32.8% had sick leaves of less than a week in duration. Lower limb injuries were associated with longer sick leaves only in patients performing strenuous jobs. Public sector workers sustaining an injury at work and performing strenuous jobs were associated with longer sick leaves. Senior workers returned earlier to work, but age and gender were not strongly correlated with long sick leaves. There was a weak but significant association between sick leave duration and the period spent refraining from hobby activities, and almost all patients returned to their work before their hobbies.

Back pain in industry. A prospective survey.

Eight hundred and two subjects employed in N.W. England have been interviewed and examined after episodes of back or sciatic pain, using a standardized procedure. Data on recurrence of symptoms leading to further treatment or absence from work in the following two 12-month periods were obtained by postal questionary. Residual pain in the leg and a number of positive clinical signs of return to work, longer sickness--absence for the current attack, and two or more previous attacks were all associated with recurrence or persistence of symptoms. The prognosis also varied according to the cause of back pain, falls being associated not only with longer periods of absence in the current attack but with a higher rate of recurrence. The results have underlined the significance of a thorough examination on return to work after back pain for the industrial medical officer, as well as the epidemiological importance of this phase in the natural history of back and sciatic pain.