1
|
Harkko J, Ranta H, Lallukka T, Nordquist H, Mänty M, Kouvonen A. Working conditions and mental health functioning among young public sector employees. Scand J Public Health 2023; 51:98-105. [PMID: 34609255 PMCID: PMC9900189 DOI: 10.1177/14034948211045458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: The associations between adverse working conditions and mental disorders are well established. However, associations between adverse working conditions and poor mental health functioning is a less explored area. This study examines these associations among younger public sector employees of the City of Helsinki, Finland. Methods: We use data from the Young Helsinki Health Study with a representative sample of the employees of the City of Helsinki, aged 19-39 years (n=4 217). Mental health functioning was measured with mental composite summary of the Short Form 36. Working conditions included factors related to both the psychosocial (job control and job demands) and the physical work environment (physical workload). To examine the associations, we used logistic regression models with adjustments for socio-demographics, other working conditions and health-related covariates. Results: After adjustment for sociodemographic characteristics, poor health, health behaviours and other occupational exposures, high job demands (OR=1.69; 95% CI=1.45-1.97) and low job control (OR=1.65; 95% CI=1.40-1.94) were associated with poor mental health functioning. High physical workload was not associated with the outcome (OR=0.87; 95% CI=0.72-1.05) after the adjustments. Conclusions: Adverse psychosocial working conditions were associated with mental health functioning, whereas physical working conditions were not. As impaired functioning is likely to cause health-related lost productivity and can lead to work disability, further research and interventions with a balanced approach focusing on both psychosocial working conditions and mental health functioning are recommended.
Collapse
Affiliation(s)
- Jaakko Harkko
- Faculty of Social Sciences, University of Helsinki, Finland
| | - Hertta Ranta
- Faculty of Social Sciences, University of Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Finland
| | - Hilla Nordquist
- Faculty of Social Sciences, University of Helsinki, Finland.,Department of Public Health, University of Helsinki, Finland.,South-Eastern Finland University of Applied Sciences, Finland
| | - Minna Mänty
- Department of Public Health, University of Helsinki, Finland.,Unit of strategy and research, City of Vantaa, Vantaa, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Finland.,Centre for Public Health, Queen's University Belfast, UK
| |
Collapse
|
2
|
Hoque Tania M, Hossain MR, Jahanara N, Andreev I, Clifton DA. Thinking Aloud or Screaming Inside: Exploratory Study of Sentiment Around Work. JMIR Form Res 2022; 6:e30113. [PMID: 36178712 PMCID: PMC9568814 DOI: 10.2196/30113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/03/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background Millions of workers experience work-related ill health every year. The loss of working days often accounts for poor well-being because of discomfort and stress caused by the workplace. The ongoing pandemic and postpandemic shift in socioeconomic and work culture can continue to contribute to adverse work-related sentiments. Critically investigating state-of-the-art technologies, this study identifies the research gaps in recognizing workers’ need for well-being support, and we aspire to understand how such evidence can be collected to transform the workforce and workplace. Objective Building on recent advances in sentiment analysis, this study aims to closely examine the potential of social media as a tool to assess workers’ emotions toward the workplace. Methods This study collected a large Twitter data set comprising both pandemic and prepandemic tweets facilitated through a human-in-the-loop approach in combination with unsupervised learning and meta-heuristic optimization algorithms. The raw data preprocessed through natural language processing techniques were assessed using a generative statistical model and a lexicon-assisted rule-based model, mapping lexical features to emotion intensities. This study also assigned human annotations and performed work-related sentiment analysis. Results A mixed methods approach, including topic modeling using latent Dirichlet allocation, identified the top topics from the corpus to understand how Twitter users engage with discussions on work-related sentiments. The sorted aspects were portrayed through overlapped clusters and low intertopic distances. However, further analysis comprising the Valence Aware Dictionary for Sentiment Reasoner suggested a smaller number of negative polarities among diverse subjects. By contrast, the human-annotated data set created for this study contained more negative sentiments. In this study, sentimental juxtaposition revealed through the labeled data set was supported by the n-gram analysis as well. Conclusions The developed data set demonstrates that work-related sentiments are projected onto social media, which offers an opportunity to better support workers. The infrastructure of the workplace, the nature of the work, the culture within the industry and the particular organization, employers, colleagues, person-specific habits, and upbringing all play a part in the health and well-being of any working adult who contributes to the productivity of the organization. Therefore, understanding the origin and influence of the complex underlying factors both qualitatively and quantitatively can inform the next generation of workplaces to drive positive change by relying on empirically grounded evidence. Therefore, this study outlines a comprehensive approach to capture deeper insights into work-related health.
Collapse
Affiliation(s)
- Marzia Hoque Tania
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Md Razon Hossain
- School of Information System, Queensland University of Technology, Brisbane, Australia
| | - Nuzhat Jahanara
- Department of Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Ilya Andreev
- School of Engineering and the Built Environment, Anglia Ruskin University, Cambridge, United Kingdom
| | - David A Clifton
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Advanced Research (OSCAR), University of Oxford, Suzhou, China
| |
Collapse
|
3
|
Uptake of Voluntary Occupational Health Care—Assessments of German Occupational Health Physicians and Employees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159602. [PMID: 35954960 PMCID: PMC9367937 DOI: 10.3390/ijerph19159602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/28/2022] [Accepted: 08/02/2022] [Indexed: 12/10/2022]
Abstract
Workers’ health surveillance is considered essential for employees’ health and protection against hazardous working conditions. It is one part of occupational health care and thus one of four pillars of holistic workplace health management. In Germany, employers are obliged to provide mandatory and voluntary occupational health care (OHC) to employees, dependent on the defined occupational hazards. However, employees are not obliged to make use of voluntary OHC. No empirical information is available about the uptake of voluntary OHC by employees and the influencing factors in Germany. Thus, we carried out an explorative multi-perspective study with qualitative and quantitative elements to get insights from the view of occupational health physicians (OHPs) and employees. We conducted a survey among OHPs based on prior statements from two focus group discussions. A multivariate logistic regression analysis was performed to detect enablers and barriers regarding employee uptake of the offered voluntary OHC. We used extended qualitative methods among employees instead of an analogous survey. In total, 460 OHPs participated in the survey (response rate 29.1%), and 25 employees took part in interviews. Most of the employees had not heard the term voluntary OHC before, and only a few remembered respective occupational health care after explanatory request. In total, 78% of the OHPs assessed that employees always/mostly take up voluntary OHC. The most important attributed reason for non-uptake was that employees see no need for occupational health care when they feel healthy. The most important enabler for the perceived high uptake of voluntary OHC in the regression analysis was a positive attitude of the OHP toward voluntary OHC. While OHPs perceived that voluntary OHC was accepted by a majority of employees, this was not confirmed by the interviews with selected employees. This could indicate that the OHP respondents overestimated the amount of uptake. Since it became clear that employees are often unfamiliar with the terminology itself, we see a need for more and better information regarding the objectives and content of occupational health care to improve this important pillar of workplace health management.
Collapse
|
4
|
Perhoniemi R, Blomgren J. Use of Health Services and Rehabilitation before and after the Beginning of Long-Term Sickness Absence-Comparing the Use by Employment and Disability Pension Transition after the Sickness Absence in Finland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4990. [PMID: 35564383 PMCID: PMC9099499 DOI: 10.3390/ijerph19094990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 02/01/2023]
Abstract
The objective of the study was to follow the health care and rehabilitation use before, during and after long-term sickness absence (LTSA), and to compare the use by post-LTSA labour market situation in terms of disability pension and employment. Individuals aged 18-58 with a ≥30-day LTSA spell in 2015 (N = 2427) were included from the total population of the city of Oulu, Finland. Register data included LTSA spells, outpatient health care visits, inpatient care spells and rehabilitation spells, disability pensions (DP), employment dates, and demographic, socioeconomic and disability-related covariates. The study population was followed for one year before, and three years after the start of LTSA. Negative binomial regression models were utilized to examine covariate-adjusted use of the three service types and group differences. The use of outpatient health care peaked at the start of the LTSA spell, and adjusted for covariates, the height of the peak was similar regardless of post-LTSA labour market situation. Adjusted for covariates, those who transferred to permanent DP after an LTSA used more outpatient (predicted mean 4.87 for attendance days quarterly, 95% CI 4.36-5.38) and inpatient (predicted mean 84 days quarterly, 95% CI 0.62-1.06) health care than others during three years after the start of LTSA. Individuals not employed after an LTSA showed the highest and increasing level of rehabilitation use. The results indicate that Individuals returning to employment after an LTSA are provided with relatively high amount of early outpatient care, possibly aiding the return. For individuals not employed after an LTSA, rehabilitation is used quite frequently but rather late in the disability process. The frequent use of health care among future disability pensioners is consistent with their increasing health problems leading to retirement.
Collapse
Affiliation(s)
- Riku Perhoniemi
- The Social Insurance Institution of Finland, 00250 Helsinki, Finland;
| | | |
Collapse
|
5
|
Perhoniemi R, Blomgren J. Outpatient healthcare use before and during a long-term sickness absence spell: a register-based follow-up study comparing healthcare use by the length of sickness absence and transition to disability pension in Finland. BMJ Open 2022; 12:e053948. [PMID: 35217537 PMCID: PMC8883273 DOI: 10.1136/bmjopen-2021-053948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The objective of the study was to examine outpatient healthcare use before and during a long-term sickness absence (LTSA), and to compare the development of healthcare use between groups defined through LTSA lengths and disability pension (DP) transition. DESIGN Register-based longitudinal study with five 6-month periods before and after the start of the LTSA spell in early 2016.LTSA groups 1 (N=210) and 2 (N=187) went on to reach the statutory maximum LTSA length, with group 1 transitioning to DP. Group 3 (N=3082) had a shorter LTSA spell. Control group 4 (N=92 921) had no LTSA. SETTING AND PARTICIPANTS Non-retired individuals aged 20-59, with no LTSA during 2015 (N=96 400) were included from the total population of the city of Oulu, Finland. Register data were linked on LTSA spells and outpatient healthcare use 2013-2018, DP status in 2018, and various covariates. MAIN OUTCOME MEASURES Negative binomial regression models were used to examine the covariate-adjusted number of healthcare visits, and to examine the association of the LTSA groups with healthcare use before and after the start of LTSA (incidence rate ratios and predicted means). RESULTS Individuals eventually reaching the maximum LTSA length (groups 1 and 2) had a higher level of healthcare use before the LTSA and especially after the start of LTSA than others. Individuals transferring to DP after the maximum LTSA (group 1) used healthcare the most after the start of LTSA. CONCLUSIONS The risk for at least 1 year's disability may be identified by frequent outpatient healthcare use years before LTSA. However, future disability retirees could not be identified through their pre-LTSA healthcare use. Instead, their high use of healthcare after the start of the LTSA was consistent with their increasing health problems leading to retirement.
Collapse
Affiliation(s)
- Riku Perhoniemi
- The Social Insurance Institution of Finland (Kela), Research Unit, Helsinki, Finland
| | - Jenni Blomgren
- The Social Insurance Institution of Finland (Kela), Research Unit, Helsinki, Finland
| |
Collapse
|
6
|
Heinonen N, Lallukka T, Lahti J, Pietiläinen O, Nordquist H, Mänty M, Katainen A, Kouvonen A. Working Conditions and Long-Term Sickness Absence Due to Mental Disorders: A Prospective Record Linkage Cohort Study Among 19- to 39-Year-Old Female Municipal Employees. J Occup Environ Med 2022; 64:105-114. [PMID: 34723911 PMCID: PMC8812422 DOI: 10.1097/jom.0000000000002421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE We examined associations between working conditions and long-term sickness absence due to mental disorders (LTSA-MD) among younger female public sector employees from different employment sectors. METHODS Survey data collected in 2017 (n = 3048) among 19- to 39-year-old female employees of the City of Helsinki, Finland, were used to examine job demands, job control, physical workload, computer work, and covariates. Register data on LTSA-MD were used over 1-year follow-up. Negative binomial regression models were applied. RESULTS Adverse psychosocial and physical working conditions were associated with higher LTSA-MD during the follow-up. Health and social care workers had the highest number of days of LTSA-MD. CONCLUSION Working conditions are important factors when aiming to prevent LTSA-MD among younger employees, in the health and social care sector in particular.
Collapse
Affiliation(s)
- Noora Heinonen
- Faculty of Social Sciences, University of Helsinki, Finland (Heinonen, Dr Nordquist, Dr Katainen, and Dr Kouvonen); Department of Public Health, Faculty of Medicine, University of Helsinki, Finland (Dr Olli, Dr Nordquist, and Dr Mänty); South-Eastern Finland University of Applied Sciences, Kotka, Finland (Dr Nordquist); Department of Public Health, Faculty of Medicine, University of Helsinki, Finland; and Unit of strategy and research, City of Vantaa, Vantaa, Finland (Dr Mänty); Centre for Public Health, Queen's University Belfast, UK (Dr Kouvonen)
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Kausto J, Rosenström TH, Ervasti J, Pietiläinen O, Kaila-Kangas L, Rahkonen O, Harkko J, Väänänen A, Kouvonen A, Lallukka T. Intervention targeted at physicians' treatment of musculoskeletal disorders and sickness certification: an interrupted time series analysis. BMJ Open 2021; 11:e047018. [PMID: 34862275 PMCID: PMC8647396 DOI: 10.1136/bmjopen-2020-047018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE An intervention was carried out at the occupational healthcare services (OHS) of the City of Helsinki beginning in 2016. We investigated the association between the intervention and employee sick leaves using interrupted time series analysis. DESIGN Register-based cohort study with a quasi-experimental study design. SETTING Employees of the City of Helsinki. PARTICIPANTS We analysed individual-level register-based data on all employees who were employed by the city for any length of time between 2013 and 2018 (a total 86 970 employees and 3 014 075 sick leave days). Sick leave days and periods that were OHS-based constituted the intervention time series and the rest of the sick leave days and periods contributed to the comparison time series. INTERVENTION Recommendations provided to physicians on managing pain and prescribing sick leave for low back, shoulder and elbow pain. OUTCOME MEASURES Number of sick leave days per month and sick leave periods per year. RESULTS For all sick leave days prescribed at OHS, there was no immediate change in sick leave days, whereas a gradual change showing decreasing number of OHS-based sick leave days was detected. On average, the intervention was estimated to have saved 2.5 sick leave days per year per employee. For other sick leave days, there was an immediate increase in the level of sick leave days after the intervention and a subsequent gradual trend showing decreasing number of sick leave days. CONCLUSIONS The intervention may have reduced employee sick leaves and therefore it is possible that it had led to direct cost savings. However, further evidence for causal inferences is needed.
Collapse
Affiliation(s)
- Johanna Kausto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Tom Henrik Rosenström
- Department of Psychology and Logopedics, University of Helsinki Faculty of Medicine, Helsinki, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jaakko Harkko
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Ari Väänänen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Administrative Data Research Centre, Queen's University Belfast, Belfast, UK
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| |
Collapse
|
8
|
Reho T, Atkins S, Korhonen M, Siukola A, Sumanen M, Viljamaa M, Uitti J, Sauni R. Sociodemographic characteristics and disability pensions of frequent attenders in occupational health primary care - a follow-up study in Finland. BMC Public Health 2021; 21:1847. [PMID: 34641841 PMCID: PMC8507378 DOI: 10.1186/s12889-021-11873-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 09/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Work disability is a complex issue that requires preventive efforts from healthcare systems and individuals, and that too often results in disability pensions (DP). While many studies have attempted to characterize risk factors of work disability, many showing for example a link between socioeconomic positions, working conditions and frequent attendance to OH primary care it is not known if frequent attendance is associated with DP despite the sociodemographic factors. This study aims to address this gap and examine the association between frequent attendance to OH primary care and DP, when adjusted by sociodemographic factors. METHODS This study combines routine medical record data of an occupational health service provider with comprehensive national registers. Medical record data were used to define groups of frequent attenders to OH primary care (FA) (1-year-FA, 2-year-FA, persistent-FA and non-FA) from 2014 to 2016. The sociodemographic factors (including i.e. educational level, occupational class, unemployment periods) were derived from Statistic Finland and DP decisions were derived from Finnish Centre for Pensions. Association of frequent attendance to OH primary care with DP decisions were analyzed and adjusted by sociodemographic factors. RESULTS In total, 66,381 patients were included. Basic and intermediate education along with manual and lower non-manual work predicted frequent attendance to OH primary care. Unemployment in 2013 did not predict frequent attendance to OH primary care. Frequent attendance to OH primary care was associated with DP within next two years, even when adjusted for sociodemographic factors. The association of frequent attendance to OH primary care with DP grew stronger as high service use persisted over time. CONCLUSIONS Frequent attendance to OH primary care is associated with DP risk in the near future despite the underlying sociodemographic differences. Patients using OH primary care services extensively should be identified and rehabilitative needs and measures necessary to continue in the work force should be explored. Sociodemographic issues that co-exist should be explored and considered when planning interventions.
Collapse
Affiliation(s)
- Tiia Reho
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland. .,Pihlajalinna Työterveys, Tampere, Finland.
| | - Salla Atkins
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Tampere University, New Social Research and Faculty of Social Sciences, Tampere, Finland
| | - Mikko Korhonen
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Anna Siukola
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Markku Sumanen
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | | | - Jukka Uitti
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.,Finnish Institute of Occupational Health, Tampere, Finland.,Clinic of Occupational Medicine, Tampere University Hospital, Tampere, Finland
| | - Riitta Sauni
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| |
Collapse
|
9
|
Lahti J, Harkko J, Nordquist H, Piha K, Pietiläinen O, Mänty M, Rahkonen O, Lallukka T, Kouvonen A. Seeing an occupational health psychologist reduces sickness absence due to mental disorders: A quasi-experimental study. Prev Med 2021; 149:106611. [PMID: 33989672 DOI: 10.1016/j.ypmed.2021.106611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/13/2021] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
Mental health problems are a major public health and work-life issue. We examined in a quasi-experimental design whether occupational health psychologist (OHP) appointment reduces subsequent sickness absence (SA) due to mental disorders among younger Finnish employees. The present study was conducted among 18-39-year-old employees of the City of Helsinki using register data from the City of Helsinki and the Social lnsurance Institution of Finland. We examined differences in SA days due to mental disorders (ICD-10, F-diagnosed sickness allowances) between those treated (at least one OHP appointment for work ability support) and the comparison group (no OHP appointment) during a one-year follow-up. The full sample (n = 2286, 84% women) consisted of employees with SA due to a diagnosed mental disorder during 2008-2017. To account for the systematic differences between the treatment and comparison groups, the included participants were matched according to age, sex, occupational class, education, previous SA, occupational health primary care visits and psychotropic medication. The weighted matched sample included 1351 participants. In the weighted matched sample, the mean of SA days due to mental disorders was 11.4 (95% CI, 6.4-16.5) for those treated (n = 238) and 20.2 (95% CI, 17.0-23.4) for the comparison group (p < 0.01) during the follow-up year. The corresponding figures in the full sample were (11.1, 6.7-15.4) days for those treated (n = 288) and (18.9, 16.7-21.1) days for the comparison group (p < 0.01). This quasi-experimental study suggests that seeing an OHP to support work ability reduces SA due to mental disorders.
Collapse
Affiliation(s)
- Jouni Lahti
- Faculty of Social Sciences, University of Helsinki, Finland.
| | - Jaakko Harkko
- Faculty of Social Sciences, University of Helsinki, Finland
| | - Hilla Nordquist
- Faculty of Social Sciences, University of Helsinki, Finland; Department of Public Health, University of Helsinki, Finland; South-Eastern Finland University of Applied Sciences, Finland
| | - Kustaa Piha
- Department of Public Health, University of Helsinki, Finland
| | | | - Minna Mänty
- Department of Public Health, University of Helsinki, Finland; City of Vantaa, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Finland; Administrative Data Research Centre (Northern Ireland), Queen's University Belfast, UK
| |
Collapse
|
10
|
Harkko J, Nordquist H, Pietiläinen O, Piha K, Mänty M, Lallukka T, Rahkonen O, Kouvonen A. Frequent short sickness absence, occupational health service utilisation and long-term sickness absence due to mental disorders among young employees. Int Arch Occup Environ Health 2021; 94:1549-1558. [PMID: 34095973 PMCID: PMC8384820 DOI: 10.1007/s00420-021-01728-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 04/01/2021] [Indexed: 11/16/2022]
Abstract
Objectives We examined whether frequent short-term sickness absence (FSTSA) and primary care use in occupational health service (OHS) were associated with medically-certified long-term sickness absence (LTSA) due to mental disorders among young employees. Methods We used record-linkage data covering the young employees (< 35 years) of the City of Helsinki, Finland (n = 8,282) from 2010 to 2014. The outcome was LTSA due to mental disorders. Cox regression models were fitted. Results FSTSAs were associated with subsequent LTSA. Also OHS use predicted LTSA due to mental disorders; however, this association was not found for those with prior FSTSA. Conclusions Both FSTSA and primary care use indicate subsequent LTSA independently, and together these indicators identify a larger proportion of individuals at risk of LTSA due to mental disorders.
Collapse
Affiliation(s)
- Jaakko Harkko
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
| | - Hilla Nordquist
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,South Eastern Finland, University of Applied Sciences, Kotka, Finland
| | - Olli Pietiläinen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kustaa Piha
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Minna Mänty
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Unit of Strategy and Research, City of Vantaa, Vantaa, Finland
| | - Tea Lallukka
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Research Institute of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,Administrative Data Research Centre, Northern Ireland, Centre for Public Health, Queen's University, Belfast, UK
| |
Collapse
|
11
|
Perhoniemi R, Blomgren J. Frequent attenders of three outpatient health care schemes in Finland: characteristics and association with long-term sickness absences, 2016-2018. BMC Public Health 2021; 21:870. [PMID: 33957897 PMCID: PMC8101095 DOI: 10.1186/s12889-021-10866-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/12/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Frequent attenders (FAs) impose a significant burden on service capacity and public health funding. Although the characteristics of the group and their risk for sickness absences (SA) have been studied, an understanding of FAs in different health care schemes is lacking. The aim of the study was to investigate FAs and their SA risk in the working-age population in public care, occupational health services (OHS) and private care schemes. The average number of SA days was also examined by diagnostic group. SETTING AND PARTICIPANTS Register data on the use of outpatient health care, sickness allowance spells and background characteristics (2015-2018) for 25-64 year old residents of the city of Oulu, Finland, (n = 91,737) were used. Subjects were categorized into non-attenders, non-frequent attenders and FAs (top decile of attenders) both for all outpatient health care and specifically for each care scheme in 2016. The number of sickness absence days was measured yearly in 2016, 2017 and 2018. The data were analyzed with descriptive methods and negative binomial regression models. RESULTS FAs consumed 31 to 44% of all visits depending on scheme in 2016. Frequent attendance was common among low socioeconomic groups in the public scheme, among lower non-manual employees and manual workers in OHS, and among entrepreneurs in the private scheme. FAs had a higher average number of SA days than others in each scheme, although group differences decreased from 2016 to 2017 and 2018. In public care, the adjusted effect of frequent attendance was strong especially for SA due to mental disorders (adjusted incidence rate ratio [IRR] for FAs 13.40), and in OHS for SA due to musculoskeletal disorders (adjusted IRR for FAs 8.68). CONCLUSION In each outpatient health care scheme, frequent attenders pose a great challenge both by consuming services and through their increased risk of disability. FAs in different schemes have partially different characteristics and risks. Common patient registers covering various service schemes would enable an identification of FAs visiting multiple schemes and services. Better coordinated services are needed for public care FAs in particular.
Collapse
Affiliation(s)
- Riku Perhoniemi
- The Social Insurance Institution of Finland, P.O. Box 450, 00056 KELA, Helsinki, Finland
| | - Jenni Blomgren
- The Social Insurance Institution of Finland, P.O. Box 450, 00056 KELA, Helsinki, Finland
| |
Collapse
|