title: Transitions between sickness absence, work, unemployment, and disability in Denmark         2004-2008.
abstract: OBJECTIVE
  Studies of labor market outcomes like sickness absence are usually restricted to a single         outcome. This paper investigates the use of multi-state models for studying multiple transitions between sick-listing,         work, unemployment, and disability pension by analyzing longitudinal register data. Every person sick-listed in Denmark         during 2004 was followed until the spring of 2008.
  
  
  METHODS
  A multi-state model was used to analyze transitions between         four states: work, sickness absence, unemployment, and disability pension. The first three are possible recurrent         states. The predictor variables include age group, gender, geographical region, chronic disease, temporary disease,         self-employment sickness absence insurance, and pregnancy. The relative effects of previous transitions were also         studied.
  
  
  RESULTS
  Risk of transition from sickness absence to disability pension differs with age and geographical         region. Those aged 20-29 years have an increased risk of transitioning from work to sickness absence and from         sickness absence to unemployment. The self-employed have increased risk of transitioning from work to sickness absence.         Those with chronic disease have increased risk of sickness absence, but also a greater probability of returning to         work. Previous sickness absence increases the risk of transitioning from work to sickness absence, from sickness         absence to unemployment, from work to unemployment, and from work to disability pension.
  
  
  CONCLUSIONS
  The multi-state         model is an effective way of analyzing register data and the transitions between sickness absence, work, unemployment,         and disability pension. These methods can be used to develop better predictive models of sickness absence, return to         work, unemployment, and disability.
authors.affiliation: National Research Center for the Working Environment (NRCWE), Lersø Parkallé 105, DK-2100 Copenhagen Ø, Denmark. jpe@arbejdsmiljoforskning.dk
authors.forename: Jacob
authors.initials: J
authors.lastname: Pedersen
authors.forename: Jakob Bue
authors.initials: JB
authors.lastname: Bjorner
authors.forename: Hermann
authors.initials: H
authors.lastname: Burr
authors.forename: Karl Bang
authors.initials: KB
authors.lastname: Christensen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D006233:Persons with Disabilities; D006801:Humans; D008875:Middle Aged; D018582:Sick Leave; D014478:Unemployment; D055815:Young Adult