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Does return to work occur earlier after work-related sick leave episodes than after non-work related sick leave episodes? A retrospective cohort study in Spain
  1. Fernando G. Benavides (fernando.benavides{at}
  1. Occupational Health Research Unit. Universitat Pompeu Fabra, Spain
    1. Consol Serra (consol.serra{at}
    1. Occupatioanl Health Research Unit.Universitat Pompeu Fabra, Spain
      1. Ruth Dominguez
      1. Occupational Health Reseach Unit. Universitat Pompeu Fabra, Spain
        1. José Miguel Martínez
        1. Occupational Health Research Unit, Spain
          1. Manel Plana
          1. Medical Division. MC Mutual, Spain
            1. Miquel Despuig
            1. Medical Divison. MC Mutual, Spain
              1. Maite Sampere
              1. Medical Divison. MC Mutual, Spain
                1. David Gimeno
                1. Department of Epidemiology and Public Health. University College London, United Kingdom


                  Objective: In Spain, sick pay benefits for work-related sick leave episodes are higher than for non work-related episodes. Our aim is to assess whether time to return to work is longer for higher paid sick leave episodes than for lower paid episodes.

                  Methods: We used data from 62,376 work-related and 76,932 non work-related sick leave episodes occurring among 338,226 workers from 56,099 companies in Spain in 2002. All episodes were followed for up to 18 months. Episodes were classified by a physician as being work or non work-related according to medicolegal judgments. The median episode duration and the 25th and 75th percentiles were calculated. The probability of remaining absent from work was estimated by a non-parametric estimator of the marginal survival function. The time ratio between both types of sick leave was estimated by a log-logistic regression model, using non-work related episodes as the reference.

                  Results: Median episode duration (25th-75th percentiles) was 11 (6-21) days for work-related episodes and 9 (4-29) days for non work-related episodes. Time to return to work was longer for work-related episodes than non work-related episodes of less than 16 days (time ratio=1.19 in men and 1.08 in women), while the opposite was observed for episodes of more than 15 days (0.58 in men and 0.40 in women).

                  Conclusions: Sick pay benefits have a limited effect on time to return to work after a short-term sick leave episode. However for longer term episodes, those receiving lower sick pay benefits took much longer to return to work.

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