Sick leave diagnoses and return to work: a Swedish register study

Abstract

Purpose: To provide a detailed description of return to work (RTW) for different diagnoses. Methods: A sample of 617 611 cases of sick leave with minimum duration of 14 days started in 2009 and 2010 was followed for 450 days. Data on sick leave episodes, diagnosis (ICD-10 codes on 3-digit level) and background factors were retrieved from Swedish National Social Insurance registers. RTW was analysed with Cox proportional hazard regression with separate analyses for women and men. Results: The diseases with the lowest RTW rates were present within malign neoplasms, severe mental disorders and severe cardiovascular diseases. High-RTW rates were present for infectious respiratory diseases, viral infections and less severe cardiovascular diseases. There were distinct differences across diagnoses within all diagnosis chapters. This also holds for mental disorders and musculoskeletal diseases, which are the most common causes of sick leave. The results for women and men across different diseases and disorders were strikingly similar. Conclusions: Systematic use of standard information such as detailed sick listing diagnosis could, at low-additional cost, pinpoint cases at risk for prolonged sick leave. The use of broad diagnosis categories in sick leave research may be questioned since there are distinct differences in RTW within ICD-10 chapters.

Implications for Rehabilitation

• Case managers’ systematic use of information on sick leave diagnosis could, at low-additional cost, pinpoint cases at risk for prolonged sick leave. Low return to work rates (RTW) are, in general, found among neoplasms, cardiovascular diseases and mental disorders.

• Alongside medical rehabilitation measures, vocational rehabilitation measures should be considered at early stages in the rehabilitation process by case managers, in collaboration with medical service providers, and employers or the employment service.

• In sick leave research, in general, and RTW research, in particular, the application of broad ranging categories of diagnoses has to be reflected on, since there are distinct differences in RTW across diagnoses within the same diagnosis chapter.

• Diagnosis
• ICD-10
• return to work
• sick leave

Acknowledgements

The author is grateful to Niklas Österlund and Andrzej Dudziuk who assisted in the preparation of the data.

Declaration of interest

The author reports no conflicts of interest.