Comparisons of sickness absence patterns, trends and attitudes in the health and care sectors in two municipalities in Norway and Denmark.

Abstract

Sickness absence is of great concern in most Western societies and has huge economic and social consequences. The Scandinavian countries, especially Norway, have high sickness absence rates. In both Norway and Denmark, the highest sickness absence rates are found in the health and care sector. The aims of this doctoral thesis are to compare the sickness absence patterns of municipal employees in the health and care sector in two comparable countries, Norway and Denmark, and to explore attitudes towards sickness absence and sickness presenteeism in nursing homes in Norway and Denmark. The thesis consists of three papers. Papers I and II are based on data from the personnel registers of the municipalities of Kristiansand, Norway and Aarhus, Denmark. These registers contain information on sickness absence for employees in the health and care sector. Paper III is based on data from focus group discussions among nursing homes employees in the same two municipalities. Paper I compares sickness absence patterns, measured as rate and number of sick leave episodes, between employees in the health and care sector of the municipality of Kristiansand, Norway and Aarhus, Denmark. We found higher sickness absence rates in Norway compared to Denmark, and employees in Denmark had more frequent, but shorter sick leave episodes compared to Norway. This may indicate that more frequent sick leave episodes prevent higher sick leave rates. In Paper II we investigated sickness absence patterns and time trends of municipal employees in the health and care sector in Kristiansand, Norway and Aarhus, Denmark. We found an overall increase in the sickness absence rate in Denmark, while the largest overall increase in number of sick leave episodes was found in Norway. The largest increase in sickness absence rates and number of sick leave episodes were observed among young employees in both countries. The results indicate that sickness absence, measured as rate and number of sick leave episodes, converged in the two countries between 2004 and 2008. In Paper III we explored attitudes towards sickness absence and sickness presenteeism among municipal employees in nursing homes in Kristiansand, Norway and Aarhus, Denmark. We found that attitudes towards sickness absence and presenteeism were socially and morally determined at the individual level by an overall perception of work, independent of country. The results from these studies indicated that the overall sickness absence rates in Denmark increased between 2004 and 2008, whereas they were stable in Norway. Sickness absence patterns, measured as rate and number of sick leave episodes, converged during the study period and the sickness absence rates in young employees increased significantly in both countries. Attitudes towards sickness absence and sickness presenteeism seemed similar, independent of country.