Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland

OBJECTIVES: Frequent attenders (FAs) create a substantial portion of primary care workload but little is known about FAs’ sickness absences. The aim of the study is to investigate how occasional and persistent frequent attendance is associated with sickness absences among the working population in o...

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Autores principales: Reho, Tiia T M, Atkins, Salla A, Talola, Nina, Sumanen, Markku P T, Viljamaa, Mervi, Uitti, Jukka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6411255/
https://www.ncbi.nlm.nih.gov/pubmed/30782922
http://dx.doi.org/10.1136/bmjopen-2018-024980
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author Reho, Tiia T M
Atkins, Salla A
Talola, Nina
Sumanen, Markku P T
Viljamaa, Mervi
Uitti, Jukka
author_facet Reho, Tiia T M
Atkins, Salla A
Talola, Nina
Sumanen, Markku P T
Viljamaa, Mervi
Uitti, Jukka
author_sort Reho, Tiia T M
collection PubMed
description OBJECTIVES: Frequent attenders (FAs) create a substantial portion of primary care workload but little is known about FAs’ sickness absences. The aim of the study is to investigate how occasional and persistent frequent attendance is associated with sickness absences among the working population in occupational health (OH) primary care. SETTING AND PARTICIPANTS: This is a longitudinal study using medical record data (2014–2016) from an OH care provider in Finland. In total, 59 676 patients were included and categorised into occasional and persistent FAs or non-FAs. Sick-leave episodes and their lengths were collected along with associated diagnostic codes. Logistic regression was used to analyse associations between FA status and sick leaves of different lengths (1–3, 4–14 and ≥15 days). RESULTS: Both occasional and persistent FA had more and longer duration of sick leave than non-FA through the study years. Persistent FAs had consistently high absence rates. Occasional FAs had elevated absence rates even 2 years after their frequent attendance period. Persistent FAs (OR=11 95% CI 7.54 to 16.06 in 2016) and occasional FAs (OR=2.95 95% CI 2.50 to 3.49 in 2016) were associated with long (≥15 days) sickness absence when compared with non-FAs. Both groups of FAs had an increased risk of long-term sick leaves indicating a risk of disability pension. CONCLUSION: Both occasional and persistent FAs should be identified in primary care units caring for working-age patients. As frequent attendance is associated with long sickness absences and possibly disability pensions, rehabilitation should be directed at this group to prevent work disability.
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spelling pubmed-64112552019-03-27 Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland Reho, Tiia T M Atkins, Salla A Talola, Nina Sumanen, Markku P T Viljamaa, Mervi Uitti, Jukka BMJ Open Public Health OBJECTIVES: Frequent attenders (FAs) create a substantial portion of primary care workload but little is known about FAs’ sickness absences. The aim of the study is to investigate how occasional and persistent frequent attendance is associated with sickness absences among the working population in occupational health (OH) primary care. SETTING AND PARTICIPANTS: This is a longitudinal study using medical record data (2014–2016) from an OH care provider in Finland. In total, 59 676 patients were included and categorised into occasional and persistent FAs or non-FAs. Sick-leave episodes and their lengths were collected along with associated diagnostic codes. Logistic regression was used to analyse associations between FA status and sick leaves of different lengths (1–3, 4–14 and ≥15 days). RESULTS: Both occasional and persistent FA had more and longer duration of sick leave than non-FA through the study years. Persistent FAs had consistently high absence rates. Occasional FAs had elevated absence rates even 2 years after their frequent attendance period. Persistent FAs (OR=11 95% CI 7.54 to 16.06 in 2016) and occasional FAs (OR=2.95 95% CI 2.50 to 3.49 in 2016) were associated with long (≥15 days) sickness absence when compared with non-FAs. Both groups of FAs had an increased risk of long-term sick leaves indicating a risk of disability pension. CONCLUSION: Both occasional and persistent FAs should be identified in primary care units caring for working-age patients. As frequent attendance is associated with long sickness absences and possibly disability pensions, rehabilitation should be directed at this group to prevent work disability. BMJ Publishing Group 2019-02-08 /pmc/articles/PMC6411255/ /pubmed/30782922 http://dx.doi.org/10.1136/bmjopen-2018-024980 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Public Health
Reho, Tiia T M
Atkins, Salla A
Talola, Nina
Sumanen, Markku P T
Viljamaa, Mervi
Uitti, Jukka
Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland
title Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland
title_full Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland
title_fullStr Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland
title_full_unstemmed Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland
title_short Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland
title_sort occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in finland
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6411255/
https://www.ncbi.nlm.nih.gov/pubmed/30782922
http://dx.doi.org/10.1136/bmjopen-2018-024980
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