Affiliations: Division of Social Medicine and Public Health Science,
Department of Health and Society, Linköpings Universitet, Linköping,
Sweden | Department of Health Science, Mid-Sweden University,
Sundsvall, Sweden | Centre for Studies on National Social Insurance,
Department of Health Science, Mid-Sweden University, Östersund,
Sweden | Department of Health Science, Mid-Sweden University,
Östersund, Sweden | Personal Injury Prevention, Department of Clinical
Neuroscience, Karolinska Institutet, Stockholm, Sweden
Note: [] Address for correspondence: Hans Goine, Lindstedtsvägen 3,
SE-871 60 Härnösand, Sweden. Tel.: +46 70 587 2350; E-mail:
hans@goine.se
Abstract: The objective was to compare the applicability of and results
provided by the two measures of sickness absence used most often within the
Swedish social insurance administration (that is, unadjusted sick-leave rate
and adjusted sick-leave rate) and five measures suggested by epidemiological
researchers. Data consisted of four cross-sectional data sets of registry
sick-leave data covering four separate years (1997–2000) in three
counties. In total 454,000 persons qualified for sickness insurance and aged
20–64 years were included. The two measures used within the social insurance administration and
three of the five measures suggested by epidemiological researchers revealed
sex-related dissimilarities in absence patterns that indicated that women had
more sickness absence than men. However, in marked contrast to those results,
two of the epidemiologically based measures (i.e., length of sickness absence
and duration of sickness absence) instead showed highly comparable rates of
sick leave for men and women, and such information is seldom obtained, albeit
definitely of importance, when trying to make a correct assessment of sickness
absence. The measure of sickness absence that is used influences the findings
and should therefore be chosen with care. Complementing the measures used in
the social insurance administration by five measures suggested by
epidemiological researchers provided a more informative and comprehensive
picture of sickness absence in a population. Further investigations into the
effect of using different measures is needed, as well as international
consensus on what to call different measures.
