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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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Abstract

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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Notes

  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.

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Correspondence to Daniela Andrén.

Appendix

Appendix

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). https://doi.org/10.1007/s10198-006-0005-6

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