Authors' objectives:

The aim of this report was to: - assess the scientific evidence about the positive and negative consequences of being sickness absent - review the research on sick leave, current knowledge of its causes, and physician sickness-certification practices - identify areas where further research is needed.

Authors' recommendations: Despite the scope of sickness absence and its heavy impact on society and the individual, there is limited knowledge about the causes and consequences of sick leave and how they can be influenced. This field of research is underdeveloped in terms of theory, methodology, and concepts. Several of the research questions explored are general in nature. Many of the questions that decision makers may ask about sick leave cannot be answered based on current scientific knowledge. This applies both to those who make decisions at the individual, workplace, and community levels. There are surprisingly few studies about the causes of sick leave and the consequences of physicians' sickness certification practices, and even fewer studies of high methodological quality. There are even fewer intervention studies, and the results are too general for practical application in the health-care system. Further development is necessary. Scientific evidence is not available to support several of the different hypotheses concerning sick leave and disability pension that have been presented. Health services need better information about the positive and negative consequences of being sickness absent in different situations, and how quickly any potentially negative effects might be expected, identified, and counteracted. Instruments for assessing work capacity also need to be developed and tested. A standard terminology is essential, eg, regarding measurements applied to sick leave. Longitudinal studies over several years, studies with relevant control groups, studies that focus on women, studies at the diagnostic level to determine appropriate sick-leave periods are needed as a basis for physicians' practices. Studies about educational and organizational changes are also needed. Simply producing more studies is, however, not enough. The methodological quality must be higher, and this requires resources in terms of, eg, financing, expertise, and good data. Only a limited number of studies address the essential aspects of sick leave, and SBU recognizes the need for qualitatively better research (such as longitudinal studies and intervention studies at the individual and group levels, eg. at workplaces).

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.sbu.se/Published

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Sweden

Organisation Name: Swedish Agency for Health Technology Assessment and Assessment of Social Services

Contact Address: P.O. Box 3657, SE-103 59 Stockholm, Sweden. Tel: +46 8 4123200, Fax: +46 8 4113260

Contact Name: registrator@sbu.se

Contact Email: registrator@sbu.se

Copyright: Swedish Council on Technology Assessment in Health Care (SBU)