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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. F G Benavides1,2,
  2. C Serra1,2,
  3. R Domínguez1,
  4. J M Martínez1,2,
  5. M Plana3,
  6. M Despuig3,
  7. M Sampere1,3,
  8. D Gimeno4,5
  1. 1
    Occupational Health Research Unit, Universitat Pompeu Fabra, Barcelona, Spain
  2. 2
    CIBER de Epidemiología y Salud Pública, Spain
  3. 3
    Medical Division, MC Mutual, Barcelona, Spain
  4. 4
    Department of Epidemiology and Public Health, University College London, London, UK
  5. 5
    The University of Texas School of Public Health, San Antonio Regional Campus, San Antonio, Texas, USA
  1. Dr Fernando G Benavides, Occupational Health Research Unit, Universitat Pompeu Fabra, Doctor Aiguader, 88, 08003 Barcelona, Spain; fernando.benavides{at}


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 medico-legal 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 for 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 sick leave episode.

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  • Funding: This study was supported by grants from the Instituto de Salud Carlos III (FIS/04/1062) and the Ministerio de Trabajo y Asuntos Sociales (FIPROS/2006/78).

  • Competing interests: None.

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