title: Predictive factors for long-term sick leave and disability pension among frequent and normal attenders in primary health care over 5 years.
abstract: OBJECTIVE
  To find predictive factors for long-term sick leave (SL) and disability pension (DP) among frequent attenders (FAs) and normal attenders (NAs) in primary health care.
  
  
  METHODS
  A cohort study with follow-up over 5 years.
  
  
  METHODS
  Groups of FAs and NAs were followed over 5 years. Information about background, situation, sociodemography, life events, social support and sense of coherence were gathered at baseline. Multiple logistic regression analysis was used to determine the influence of each variable on long-term SL and receipt of a DP.
  
  
  RESULTS
  During the study period, 18.9% of FAs received long-term SL/DP compared with 6% of NAs. Chronic disease was a predictive factor for long-term SL/DP among FAs [odds ratio (OR) 7.0] and NAs (OR 3.4). Among FAs, a life event was also a predictive factor (OR 2.1). Each additional life event increased the ratio of FAs with long-term SL/DP by 110%. Conflicts and losses had the greatest negative effects on FAs.
  
  
  CONCLUSIONS
  FAs are a high-risk group for long-term SL/DP. Besides chronic disease, a life event was the only predictive factor for long-term SL/DP among FAs. These findings indicate that FAs are a vulnerable group for stressful events. Consequently, healthcare personnel should take more notice of life events among FAs.
authors.affiliation: Research and Development Unit, Primary Health Care, Halland County Council, Falkenberg, Sweden. hakan.bergh@lthalland.se
authors.forename: Håkan
authors.initials: H
authors.lastname: Bergh
authors.forename: Amir
authors.initials: A
authors.lastname: Baigi
authors.forename: Jörgen
authors.initials: J
authors.lastname: Månsson
authors.forename: Bengt
authors.initials: B
authors.lastname: Mattsson
authors.forename: Bertil
authors.initials: B
authors.lastname: Marklund
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D018868:Insurance, Disability / Q000706:statistics & numerical data*; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010415:Pensions / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors