[Problematic sickness absence: a quantitative and qualitative analysis].
OBJECTIVE
In the Netherlands, an occupational physician supports absence management and staff's return to work, but this role may be hampered if there is uncertainty concerning return to labour options. The return to work process may be improved when a specialized second opinion organization is called upon. Our objective was to map the potential for deployment, return to work rates, and healthcare costs for staff with problematic sickness absence profiles.


METHODS
We analysed the data of problematic absentees who passed through a second opinion advisory system between 2011-2014, using pseudo-anonymized data matching from various sources. The datasets include client data from a company providing second opinions (n = 2595), a questionnaire for employees (n = 1800), a questionnaire for referrers (n = 400), additional data from one case management company (n = 564) and claims data from a health insurance company (n = 725).


RESULTS
Among the problematic absentees, 49% concerned musculoskeletal problems, compared to 23% mental health problems, 14% multifactorial problems, and 16% other problems; 29% concerned limitations restricting return to work. In 51% of the cases, physicians representing the second opinion company concluded that current treatment was inadequate. Fifty-three percent of the referrers responded that the second opinion usually led to a change in treatment. In 31% of cases, employees felt that the second opinion system did not contribute to the return to work process. Average annual health costs of problematic absentees were €7800, compared to €2600 before sickness absence commenced.


CONCLUSIONS
Many employees with problematic sickness absence are not treated adequately; opportunities to return to work are not utilized and the treatment is often not sufficiently focused on functional recovery. In principle, (partial) return to work is deemed possible for the majority of cases.
Radboudumc, afd. IQ healthcare en Celsus academie voor betaalbare zorg, Nijmegen.
P J
PJ
van der Wees
N
N
Stadhouders
J B
JB
Staal
P P T
PP
Jeurissen
D000041:Absenteeism; D000328:Adult; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D009426:Netherlands; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires