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Sweden better than rumor. Sick leave is at a record – nine out of ten Swedes did not get any sickness benefit at all in 2013. Sick Century, the figure commonly used in the analysis, is a blunt analysis tools. In fact, seem to changes in health insurance have worked well, writes John Selander, professor of rehabilitation science.
Sweden better than rumor. Sick leave is at a record – nine out of ten Swedes did not get any sickness benefit at all in 2013. Sick Century, the figure commonly used in the analysis, is a blunt analysis tools. In fact, seem to changes in health insurance have worked well, writes John Selander, professor of rehabilitation science.
Almost always when the Swedish sickness absence analyzed so it is assumed something of the Social Insurance various ohälsomått. The most common is that the analysis is based on the so-called sick century, most recently in Dagens Nyheter (8/11) under the heading “Rampant sick if nothing is done.” Ill figure is the average number of days of sickness benefit per Swedish and years and in recent decades has varied between 10 and 25 days. As a reader, one can then easily believe that the average Swede is on sick leave two, three or four weeks a year, but it’s not. Ill figure thus gives a distorted picture of reality.
The problem is that sick rate is greatly influenced by the longest sickness cases and the relatively few cases going on throughout the year, ie 365 days. If instead one looks at the number of people on sick leave, so the picture is different. In 2013 received 558 000 people at some time during the year sickness benefit from the Social Insurance Agency, which represents about 10 percent of the total number of insured when sickness and activity compensation (formerly disability and sickness benefits) are excluded. Nine out of ten Swedes received thus no sickness at all during 2013.
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An internationally recognized way to measure sickness absence is to investigate what proportion of those who have a job (employees and self-employed) who are temporarily away from work due to illness a regular work week. In Sweden made it by Statistics Sweden and international data compiled by the EU’s statistics office, Eurostat. In such an analysis emerges another, and in many ways more accurate picture of the Swedish sickness absence.
First , we see that Swedish men in a European perspective does not differ from men in other comparable countries. During the period 2000-2013 is the absence among Swedish men on average 2.2 percent, which is slightly lower than men in the countries compared.
Second , we see that Swedish women have higher sickness absence than their European sisters until 2003/2004, and that the absence thereafter decreases. That women are more sick leave than men is not unique to Sweden, but in no other country has the difference between men and women been so great. The reasons that women are more sick leave than men are multiple, inter alia, that women are over-represented in the public sector, and that women often have dual responsibilities, both as professionals and home.
Third , we see that the sick leave in Sweden today is in line with the rest of Europe. Swedes since 2006/2007 neither more nor less sick leave than others, and that applies to both men and women.
Fourth , we see that the overall reduction in sickness absence that occurred in Sweden between 2003 and 2010, mainly explained by a reduction in absenteeism among women. All diagnostic groups has decreased, but the diagnostic group that has fallen at least the psychological problems which have resulted in the proportion with mental disorders has increased and that the diagnostic group today is the most common among those on sick leave, among both men and women.
How is explained as the fact that Sweden today has a record of sick leave that is clearly in line with the rest of Europe? No clear explanation exists, but it is instead of several interacting factors. One factor is that health insurance attraction has decreased. In 2007, introduced the so-called earned income tax credit, which in a direct way increased the financial incentives to work rather than receive compensation in the form of grants. That individual is affected by economic incentives is a research-coated fact. Another factor is the regulatory changes that have been made in health insurance. In 2008, the so-called rehabilitation chain, which means stringent requirements for the granting of sickness benefit. Individual’s work should not only be judged on his or her regular work, but after a time, based on other work which the employer can offer, and after a further period outside normal working of the labor market. According to the Social I nsurance Agency’s own analysis has rehabilitation chain had great significance for today’s low sickness absence. The year 2008 was also a time limit on how long you can receive sickness benefit. Before that there was no such time limit, something that was completely unique to Sweden.
Another reason to the low sickness absence is the relatively high unemployment. History shows a strong correlation. When unemployment goes up, so go down sick leave, which is mainly explained by the individual wants to avoid sick leave when the threat of unemployment exists. Unemployment soared during the economic crisis of 2008 and is since then around 8 percent. New research also shows that rehabilitation work, everything works better and that employers significantly higher rate than before take active responsibility for employees who are on sick leave. Research also shows that long-term sick usually experience a level of support from colleagues. There is strong evidence that an active employer and a welcoming workplace greatly affect the return to work. How these factors affect individual absenteeism is difficult to determine, but overall, they have a significant effect, and especially for women.
The recent changes in sick leave is gratifying. Health insurance is politically charged and opinions about its design differ greatly, but fewer people of working age are sick should, regardless of their political base, basically seen as something positive. The benefits of a lower absenteeism are many, both for individual, organization of society.
Sweden have today a historically low absenteeism, fully comparable with that in the rest of Europe. This gives us a unique opportunity to work together to stabilize at these low levels. If that decision makers care about a low absenteeism in the future, you should not change the laws and rules that largely explains the current low levels. As a researcher in the field of work and health, I see great potential in effective interventions to prevent and avoid sick leave, and a powerful work of rehabilitation, but we must for the sake do not ignore other knowledge available in the area.
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