18 research outputs found
Evaluación de la gestión de los casos de incapacidad temporal por contingencia común de más de 15 dÃas en Cataluña Evaluation of the management of nonwork-related sick leave lasting more than 15 days in Catalonia (Spain)
Objetivos: Comparar la duración de los casos de incapacidad temporal por contingencia común gestionados por las mutuas con los gestionados por el Instituto Nacional de la Seguridad Social (INSS). Métodos: Cohorte retrospectiva de 289.686 casos de incapacidad de más de 15 dÃas de duración iniciados en 2005 tras su certificación por un médico de primaria en Cataluña (156.676 gestionados por el INSS), registrados en el Institut Català d'Avaluacions Mèdiques, y seguidos hasta su alta. La duración mediana y los percentiles fueron calculados con el estimador de Wang-Chang, que tiene en cuenta los episodios repetidos (25% aproximadamente), y se compararon mediante un modelo de regresión log-logÃstico con fragilidad gamma compartida, lo que permite estimar la razón de tiempo (RT) y su intervalo de confianza del 95% (IC95%). Resultados: La duración mediana fue de 43 dÃas para los casos del INSS y de 39 para los de mutuas. Esta diferencia fue estadÃsticamente significativa para los hombres del régimen general (RT=0,87; IC95%: 0,85-0,88) y del régimen de autónomos (RT=0,78; IC95%: 0,75-0,80), y para las mujeres del régimen general (RT=0,85; IC95%: 0,84-0,87) y de autónomos (RT=0,84; IC95%: 0,81-0,88); diferencias que se mantienen en general después de ajustar por la edad y la región sanitaria. Conclusiones: Los resultados confirman una finalización de los episodios más rápida para los casos de más de 15 dÃas de duración gestionados por una mutua que para los gestionados por el INSS, tanto aquellos del régimen general como de autónomos. Es necesario investigar las causas de estas diferencias.Objectives: To compare the length of nonwork-related sick leave among cases managed by an insurance company versus those managed by the National Institute of Social Security (NISS). Methods: We performed a retrospective cohort study of 289,686 cases of sick leave lasting for more than 15 days that began in 2005 after certification by a primary care physician in Catalonia, were reported to the Catalonian Institute of Medical Evaluations, and were followed to term. Of the total, 156,676 cases were managed by the NISS. To account for repeat episodes (approximately 25% of the total), the Wang-Chang estimator was used to calculate the median duration and percentiles; comparisons were made using log-logistic regression with shared gamma frailty models, with calculation of time ratios (TR) and their corresponding 95% confidence intervals (95% CI). Results: The median duration of sick leave was 43 days for cases managed by the NISS and 39 days for those managed by the insurance company. This difference was statistically significant both for men employed under contract (TR=0.87; 95% CI: 0.85-0.88) and for those who were self-employed (TR=0.78; 95% CI: 0.75-0.80) as well as for women under contract (TR=0.85; 95% CI: 0.84-0.87) and self-employed women (TR=0.84; 95% CI: 0.81-0.88). These differences persisted after adjustment was performed for age and health region. Conclusions: For sick leave lasting more than 15 days, these results confirm that cases managed by an insurance company ended earlier than for those managed by the NISS, both for contract and self-employed workers. Further research is needed to explore the reasons for these differences
Distribución de la duración de la incapacidad temporal por contingencia común por diagnóstico médico (Cataluña, 2006-2008) Distribution of the duration of nonoccupational sick leave by medical diagnosis (Catalonia, Spain, 2006-2008)
Presentamos una herramienta sencilla y práctica que permite consultar la distribución habitual de la duración de la incapacidad temporal por contingencia común, según el diagnóstico médico. Para ello se analizaron 2.646.352 episodios de incapacidad temporal ocurridos en Cataluña y seguidos hasta el alta, entre 2006 y 2008, incorporados a un aplicativo. La duración mediana, dado que sigue una distribución asimétrica, fue de 9 dÃas. Los trastornos musculoesqueléticos fueron el grupo diagnóstico más frecuente (22,5%) y las neoplasias tuvieron la duración mediana más larga (56 dÃas). Los diagnósticos especÃficos más comunes fueron la diarrea-gastroenteritis (8,2%; mediana: 3 dÃas) y la rinofaringitis aguda (5,2%; mediana: 4 dÃas). La distribución de la duración de la incapacidad temporal en una población varÃa por diagnóstico y es asimétrica; la mayorÃa de los episodios duran mucho menos que la media. Esta información es importante para una mejor gestión, tanto clÃnica como administrativa, de la incapacidad temporal.We present a simple and practical tool that allows the usual distribution of the duration of non-occupational sick leave to be determined by medical diagnosis. A total of 2,646,352 episodes of medically certified sick leave, registered by the Catalan Institute of Medical Evaluations for the period 2006-2008, were followed to closure and were entered into a spreadsheet. Given its asymmetric distribution, the median duration of sick leave was 9 days. Musculoskeletal disorders were the most frequent diagnostic group (22.5%), while neoplasms had the longest median duration (56 days). The most common specific diagnoses were diarrhea-gastroenteritis (8.2%; median: 3 days) and acute rhinopharyngitis (5.2%; median: 4 days). The distribution of the duration of sick leave in a population varies by diagnosis and is asymmetric, with most episodes being much shorter than the mean duration. This finding is important for better clinical and administrative management of sick leave episodes
Evaluación de la gestión de los casos de incapacidad temporal por contingencia común de más de 15 dÃas en Cataluña
OBJECTIVES: To compare the length of nonwork-related sick leave among cases managed by an insurance company versus those managed by the National Institute of Social Security (NISS). METHODS: We performed a retrospective cohort study of 289,686 cases of sick leave lasting for more than 15 days that began in 2005 after certification by a primary care physician in Catalonia, were reported to the Catalonian Institute of Medical Evaluations, and were followed to term. Of the total, 156,676 cases were managed by the NISS. To account for repeat episodes (approximately 25% of the total), the Wang-Chang estimator was used to calculate the median duration and percentiles; comparisons were made using log-logistic regression with shared gamma frailty models, with calculation of time ratios (TR) and their corresponding 95% confidence intervals (95% CI). RESULTS: The median duration of sick leave was 43 days for cases managed by the NISS and 39 days for those managed by the insurance company. This difference was statistically significant both for men employed under contract (TR=0.87; 95% CI: 0.85-0.88) and for those who were self-employed (TR=0.78; 95% CI: 0.75-0.80) as well as for women under contract (TR=0.85; 95% CI: 0.84-0.87) and self-employed women (TR=0.84; 95% CI: 0.81-0.88). These differences persisted after adjustment was performed for age and health region. CONCLUSIONS: For sick leave lasting more than 15 days, these results confirm that cases managed by an insurance company ended earlier than for those managed by the NISS, both for contract and self-employed workers. Further research is needed to explore the reasons for these differences.Este trabajo ha contado con la financiación de una beca (I. Torá) para la realización de un máster en Salud Laboral, concedida mediante convocatoria pública, fruto de un convenio entre la Universitat Pompeu Fabra y el Institut Català d’Avaluacions Mèdiques, con la finalidad exclusiva de financiar esta beca
Occupational health impact of the 2009 H1N1 flu pandemic: Surveillance of sickness absence
Objectives: Workplace absences due to illness can disrupt usual operations and increase costs for businesses. This study of sickness absence due to influenza and influenza-related illness presents a unique opportunity to characterise and measure the impact of the 2009 (H1N1) pandemic, by comparing trends during the pandemic to those of previous years, and adding this information to that obtained by traditional epidemiological surveillance systems. Methods: We compared the numbers of cases of sickness absence due to illness caused by influenza and influenza-related illness in 2007-2009, and in the first 3 months of 2010 in Catalonia (n=811 940) using a time series approach. Trends were examined by economic activity, age and gender. The weekly endemic-epidemic index (EEI) was calculated and its 95% CI obtained with the delta method, with observed and expected cases considered as independent random variables. Results: Influenza activity peaked earlier in 2009 and yielded more cases than in previous years. Week 46 (in November 2009) had the highest number of new cases resulting in sickness absence (EEI 20.99; 95% CI 9.44 to 46.69). Women and the 'education, health and other social activities' sector were the most affected. Conclusions: Results indicate that the new H1N1 pandemic had a significant impact on business, with shifts in the timing of peak incidence, a doubling in the number of cases, and changes in the distribution of cases by economic activity sector and gender. Traditional epidemiological surveillance systems could benefit from the addition of information based on sickness absence data.Peer Reviewe
Comparisson in Andalusia and Catalonia of sickness absence because of influenza (H1N1) 2009 | Comparación entre AndalucÃa y Cataluña de la frecuencia de incapacidad laboral durante la gripe (H1N1) 2009
Background: This study compared surveillance of cases of sickness absence due to illness caused by influenza and reported in Andalusia and Catalonia in the period 2007-2009. Methods:Atime series of incident cases of sickness absence due to influenza, by sex and age, in which episodes in Andalusia and Catalonia in a previous epidemic period (from 01/01/2007 through 30/09/2009) were compared to the pandemic period (last three months of 2009). The weekly number of new cases of sickness absence due to influenza was calculated, and the minimum, median and maximum values were plotted for each of these two periods. Results: Unexpectedly, women had a higher proportion of new cases of sickness absence due to influenza during the pandemic period (52.2% in Catalonia and 49.7% in Andalusia). During both periods the 25 to 34 year old age group had a higher number of new cases of sickness absence both in Catalonia (37.439 in the epidemic period and 15.379 in the pandemic) and Andalusia (20.465 epidemic period and 9.630 pandemic period).The arrival of the pandemic was around November (approximately 10.000 cases in Catalonia and 5.000 cases in Andalusia), resulting in a significant increase of cases in contrast to the median of the epidemic period. Conclusions: During the 2009 pandemic, there was an increase in new cases of sickness absence due to influenza, somewhat greater in Catalonia than Andalusia, with an earlier peak in November, especially among women in these two autonomous communities.Background: This study compared surveillance of cases of sickness absence due to illness caused by influenza and reported in Andalusia and Catalonia in the period 2007-2009.
Methods: A time series of incident cases of sickness absence due to influenza, by sex and age, in which episodes in Andalusia and Catalonia in a previous epidemic period (from 01/01/2007 through 30/09/2009) were compared to the pandemic period (last three months of 2009). The weekly number of new cases of sickness absence due to influenza was calculated, and the minimum, median and maximum values were plotted for each of these two periods.
Results: Unexpectedly, women had a higher proportion of new cases of sickness absence due to influenza during the pandemic period (52.2% in Catalonia and 49.7% in Andalusia). During both periods the 25 to 34 year old age group had a higher number of new cases of sickness absence both in Catalonia (37.439 in the epidemic period and 15.379 in the pandemic) and Andalusia (20.465 epidemic period and 9.630 pandemic period). The arrival of the pandemic was around November (approximately 10.000 cases in Catalonia and 5.000 cases in Andalusia), resulting in a significant increase of cases in contrast to the median of the epidemic period.
Conclusions: During the 2009 pandemic, there was an increase in new cases of sickness absence due to influenza, somewhat greater in Catalonia than Andalusia, with an earlier peak in November, especially among women in these two autonomous communities.Peer reviewe
Duración de los episodios de incapacidad temporal por contingencia común según regiones sanitarias en Cataluña
Fundamentos: En este estudio se analizó la duración de los episodios
de incapacidad temporal por contingencia común en Cataluña
según regiones sanitarias. Partiendo de la hipótesis de una distribución
homogénea de las duraciones entre las regiones sanitarias.
Métodos: Estudio de cohorte retrospectiva de 811.790 episodios
obtenidos del Institut Català d�Avaluacions Mèdiques iniciados el
año 2005 y seguidos hasta su finalización, cómo máximo julio de
2007, donde se describió la mediana de la duración en dÃas de los episodios
para cada una de las siete regiones sanitarias de Cataluña. La
probabilidad de volver al trabajo se representó según las curvas de
supervivencia de Wang_Chang y se comparó la duración mediana
(DM) tomando como referencia la Región Sanitaria Barcelona,
estratificando por sexo.
Resultados: La región de Camp de Tarragona registra la menor
duración de 5 dÃas. Por contra, los episodios ocurridos en el Alt Pirineu
i Aran presentaron una mayor duración de 13 dÃas. Para la región
de Barcelona la duración fue 7 dÃas, al igual que para Cataluña Central.
En Girona fue de 8 dÃas, y en Lleida y Terres de l�Ebre de 9 dÃas.
Conclusiones: Existen diferencias significativas en las duraciones
de los episodios entre las regiones sanitarias de Cataluña, que se
mantienen después de ajustar por la edad, la gestión del episodio y el
régimen de Seguridad Social, tanto para hombres como para mujere
Duración de los episodios de incapacidad temporal por contingencia común según regiones sanitarias en Catalunya
Fundamentos: En este estudio se analizó la duración de los episodios de incapacidad temporal por contingencia común en Cataluña según regiones sanitarias. Partiendo de la hipótesis de una distribución homogénea de las duraciones entre las regiones sanitarias. Métodos: Estudio de cohorte retrospectiva de 811.790 episodios obtenidos del Institut Català d’Avaluacions Mèdiques iniciados el año 2005 y seguidos hasta su finalización, cómo máximo julio de 2007, donde se describió la mediana de la duración en dÃas de los episodios para cada una de las siete regiones sanitarias de Cataluña. La probabilidad de volver al trabajo se representó según las curvas de supervivencia de Wang_Chang y se comparó la duración mediana (DM) tomando como referencia la Región Sanitaria Barcelona, estratificando por sexo. Resultados: La región de Camp de Tarragona registra la menor duración de 5 dÃas. Por contra, los episodios ocurridos en el Alt Pirineu i Aran presentaron una mayor duración de 13 dÃas. Para la región de Barcelona la duración fue 7 dÃas, al igual que para Cataluña Central. En Girona fue de 8 dÃas, y en Lleida y Terres de l’Ebre de 9 dÃas. Conclusiones: Existen diferencias significativas en las duraciones de los episodios entre las regiones sanitarias de Cataluña, que se mantienen después de ajustar por la edad, la gestión del episodio y el régimen de Seguridad Social, tanto para hombres como para mujeres
Evaluación de la gestión de los casos de incapacidad temporal por contingencia común de más de 15 dÃas en Cataluña
OBJECTIVES: To compare the length of nonwork-related sick leave among cases managed by an insurance company versus those managed by the National Institute of Social Security (NISS). METHODS: We performed a retrospective cohort study of 289,686 cases of sick leave lasting for more than 15 days that began in 2005 after certification by a primary care physician in Catalonia, were reported to the Catalonian Institute of Medical Evaluations, and were followed to term. Of the total, 156,676 cases were managed by the NISS. To account for repeat episodes (approximately 25% of the total), the Wang-Chang estimator was used to calculate the median duration and percentiles; comparisons were made using log-logistic regression with shared gamma frailty models, with calculation of time ratios (TR) and their corresponding 95% confidence intervals (95% CI). RESULTS: The median duration of sick leave was 43 days for cases managed by the NISS and 39 days for those managed by the insurance company. This difference was statistically significant both for men employed under contract (TR=0.87; 95% CI: 0.85-0.88) and for those who were self-employed (TR=0.78; 95% CI: 0.75-0.80) as well as for women under contract (TR=0.85; 95% CI: 0.84-0.87) and self-employed women (TR=0.84; 95% CI: 0.81-0.88). These differences persisted after adjustment was performed for age and health region. CONCLUSIONS: For sick leave lasting more than 15 days, these results confirm that cases managed by an insurance company ended earlier than for those managed by the NISS, both for contract and self-employed workers. Further research is needed to explore the reasons for these differences.Este trabajo ha contado con la financiación de una beca (I. Torá) para la realización de un máster en Salud Laboral, concedida mediante convocatoria pública, fruto de un convenio entre la Universitat Pompeu Fabra y el Institut Català d’Avaluacions Mèdiques, con la finalidad exclusiva de financiar esta beca
Occupational health impact of the 2009 H1N1 flu pandemic: surveillance of sickness absence
Distribución de la duración de la incapacidad temporal por contingencia común por diagnóstico médico (Cataluña, 2006-2008)
Presentamos una herramienta sencilla y práctica que permite consultar la distribución habitual de la duración de la incapacidad temporal por contingencia común, según el diagnóstico médico. Para ello se analizaron 2.646.352 episodios de incapacidad temporal ocurridos en Cataluña y seguidos hasta el alta, entre 2006 y 2008, incorporados a un aplicativo. La duración mediana, dado que sigue una distribución asimétrica, fue de 9 dÃas. Los trastornos musculoesqueléticos fueron el grupo diagnóstico más frecuente (22,5%) y las neoplasias tuvieron la duración mediana más larga (56 dÃas). Los diagnósticos especÃficos más comunes fueron la diarrea-gastroenteritis (8,2%; mediana: 3 dÃas) y la rinofaringitis aguda (5,2%; mediana: 4 dÃas). La distribución de la duración de la incapacidad temporal en una población varÃa por diagnóstico y es asimétrica; la mayorÃa de los episodios duran mucho menos que la media. Esta información es importante para una mejor gestión, tanto clÃnica como administrativa, de la incapacidad temporal