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Long-term absenteeism due to sickness in Sweden. How long does it take and what happens after?

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In this paper, we analyze exits from long-term sickness spells in Sweden. Using data for more than 2,500 people, the aim is to analyze the transition to different states: return to work, full disability pension, partial disability pension, and other exits from the labor force. Given the complexity of the exit decision, which encompasses both the individual’s choice, the medical evaluation and the decision of the insurance adjudicator, we consider the outcome as being the result of two aspects of the exit process: one that governs the duration of a spell prior to the decision to exit, and another that governs the type of exit. Therefore, the analysis is done in two steps: first, we analyze the duration of the sickness spells, and then we analyze the process that governs the type of exit. The results indicate that both individual characteristics and push factors, such as regional unemployment, are important for both components of the decision process.

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  1. See Haveman and Wolfe’s [12] survey and discussion of the main lines of economic research addressing the issues of economic status and behavior of the working-age population with disabilities.

  2. Bound and Burkhauser [8] reviewed the literature on the labor supply of people with disability and how it is affected by disability program characteristics. They concluded that empirical analyses of programs targeted at individuals with disabilities have focused almost exclusively on trying to understand the behavioral effects of such programs.

  3. At the end of the observation period, on 31 December 1991, 1 EUR  = 7.4509 SEK.

  4. See “Social Insurance Statistics FACTS 1993” for more information about changes in the social-insurance rules.

  5. See [1] for a description of these models.

  6. Using Hausman’s test for independence of irrelevant alternatives, the null hypothesis cannot be rejected (Table 5 in the Appendix). This means that, given any particular observation, the ratio of the choice probabilities of any two alternatives of the response variable is not systematically influenced by other alternatives.

  7. The relative-risk ratios report the exponentiated value of the coefficient, exp(β). If the relative risk is r, and returning to work is the reference category, this means that the relative risk of the exit j over return-to-work ratio is r for cases when a dummy variable takes value 1 relative to cases with zero value; or r for one-unit change in a continuous variable. Then, the likelihood of choosing a non-working exit (full disability, partial disability, or other exit) can then be compared with that of returning to work.


  1. Andrén, D.: Exits from long-term sickness in Sweden, working paper in economics, no 48. Department of Economics, Göteborg University, Göteborg (2001a)

  2. Andrén, D.: Long-term absenteeism due to sickness: the Swedish experience, 1986–1991, working paper in economics, no 47. Department of Economics, Göteborg University, Göteborg (2001b)

  3. Andrén, D.: Never on a Sunday: economic incentives and short-term sick leave in Sweden. Appl. Econ. 37, 327–338 (2005)

    Article  Google Scholar 

  4. Andrén, D., Palmer, E.: The effect of sickness on earnings in Sweden, working paper in economics, no 45. Department of Economics, Göteborg University, Göteborg (2001)

  5. Becker, G.S.: Human capital. Columbia University Press for the National Bureau of Economic Research, New York (1964)

  6. Becker, G.S.: Human capital and the personal distribution of income: an analytical approach. University of Michigan, Ann Arbor (1967)

  7. Ben-Porath, Y.: The production of human capital and the life cycle of earnings. J. Polit. Econ. 75, 353–367 (1967)

    Article  Google Scholar 

  8. Bound, J., Burkhauser, R.: Economic analysis of transfer programs targeted on people with disabilities. In: Ashenfelter, O., Card, D. (eds.) Handbook of labor economics, pp. 3417–3528. North Holland Press, Amsterdam (1999)

    Google Scholar 

  9. Broström, G., Johansson, P., Palme, M.: Economic incentives and gender differences in work absence behavior. Working paper 2002: 14. Institute for Labour Market Policy Evaluation (IFAU), Uppsala (2002)

  10. Bäckman, O.: Longitudinal studies on sickness absence in Sweden, dissertation series no. 34. Swedish Institute for Social Research, Stockholm (1998)

  11. Fuchs, V.R.: The contribution of health services to the American economy. Milbank Memor Fund Q 44, 65–102 (1966)

    Article  Google Scholar 

  12. Haveman, R.H., Wolfe, B.L.: The economics of disability and disability policy. In: Culyer, A.J., Newhouse, J.P. (eds.) Handbook of health economics, vol. 1b, pp. 996–1051. Elsevier, Amsterdam (2000)

  13. Henrekson, M., Persson, M.: The effects on sick leave of changes in the sickness insurance system. J. Labor Econ. 22, 87–114 (2004)

    Article  Google Scholar 

  14. Johansson, P., Brännäs, K.: A household model for work absence. Appl. Econ. 30, 1493–1503 (1998)

    Article  Google Scholar 

  15. Johansson, P., Palme, M.: Do economic incentives affect work absence? Empirical evidence using Swedish micro data. J. Pub. Econ. 59, 195–218 (1996)

    Article  Google Scholar 

  16. Johansson, P., Palme, M.: Assessing the effect of public policy on worker absenteeism. J. Human Resour. 37, 381–409 (2002)

    Article  Google Scholar 

  17. Lantto, K., Lindblom, E.: Är arbetslösheten Hälsosam? [Is unemployment healthy?]. Ekonomisk Debatt 15, 333–336 (1987)

    Google Scholar 

  18. Lidwall, U., Skogman Thoursie, P.: Sickness absence and disability pensioning during the last decades. In: Staffan, M. (ed.) Work life and health in Sweden. The National Institute for Working Life and The National Board of Occupational Safety and Health, Stockholm (2000)

  19. Mincer, J.: Schooling, experience, and earnings. Human behavior & social institutions no. 2. National Bureau of Economic Research, New York (1974)

  20. Mushkin, S.J.: Health as an investment. Part 2: Investment in human beings. J. Polit. Econ. 70(5), 129–157 (1962)

    Google Scholar 

  21. National Social Insurance Board.: Facts on the Swedish social insurance 1992. RFV, Stockholm (1993)

  22. Skogman Thoursie, P.: Reporting sick: are sporting events contagious? J. Appl. Econ. 19(6) (2004)

  23. The National Social Insurance Board.: Long spells of sickness, rehabilitation and disability—a system analysis. RFV, Stockholm (1998)

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Correspondence to Daniela Andrén.



Tables 4 and 5.

Table 4 Mean and SD by individual at the beginning of the first spell of long-term sickness
Table 5 Hausman’s test for assumption “independence of irrelevant alternatives”

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Andrén, D. Long-term absenteeism due to sickness in Sweden. How long does it take and what happens after?. Eur J Health Econ 8, 41–50 (2007).

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