title: Sickness absence in hospital physicians: 2 year follow up study on determinants.
abstract: OBJECTIVE
  To identify determinants of sickness absence in hospital physicians.
  
  
  METHODS
  The Poisson regression analyses of short (1--3 days) and long (>3 days) recorded spells of sickness absence relating to potential determinants of sickness absence were based on a 2 year follow up period and cohorts of 447 (251 male and 196 female) physicians and 466 controls (female head nurses and ward sisters).
  
  
  RESULTS
  There were no differences in health outcomes, self rated health status, prevalence of chronic illness, and being a case on the general health questionnaire (GHQ), between the groups but physicians took one third to a half the sick leave of controls. All the health outcomes were strongly associated with sickness absence in both groups. Of work related factors, teamwork had the greatest effect on sickness absence in physicians but not in the controls. Physicians working in poorly functioning teams were at 1.8 (95% confidence interval (95% CI) 1.3 to 3.0) times greater risk of taking long spells than physicians working in well functioning teams. Risks related to overload, heavy on call responsibility, poor job control, social circumstances outside the workplace, and health behaviours were smaller.
  
  
  CONCLUSIONS
  This is the first study of hospital physicians to show the association between recorded sickness absence and factors across various areas of life. In this occupational group, sickness absence is strongly associated with health problems, and the threshold for taking sick leave is high. Poor teamwork seems to contribute to the sickness absenteeism of hospital physicians even more than traditional psychosocial risks-such as overload and low job control. These findings may have implications for training and health promotion in hospitals.
authors.affiliation: University of Helsinki, Department of Psychology, Division of Applied Psychology, PO Box 13, FIN-00014 Helsinki, Finland. mika.kivimaki@occuphealth.fi
authors.forename: M
authors.initials: M
authors.lastname: Kivimäki
authors.forename: R
authors.initials: R
authors.lastname: Sutinen
authors.forename: M
authors.initials: M
authors.lastname: Elovainio
authors.forename: J
authors.initials: J
authors.lastname: Vahtera
authors.forename: K
authors.initials: K
authors.lastname: Räsänen
authors.forename: S
authors.initials: S
authors.lastname: Töyry
authors.forename: J E
authors.initials: JE
authors.lastname: Ferrie
authors.forename: J
authors.initials: J
authors.lastname: Firth-Cozens
mesh_terms: D000328:Adult; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D010348:Patient Care Team; D016012:Poisson Distribution; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications