Marcelo Rivano Fischer, Elisabeth B. Persson, Britt-Marie Stålnacke, Marie-Louise Schult, Monika Löfgren
Department of Rehabilitation Medicine, Lund University Hospital, SE-221 85 Lund, Sweden. E-mail: marcelo.rivano@med.lu.se
DOI: 10.2340/16501977-2544

Objectives: To investigate: (i) changes in sick-leave benefits from 1 year prior to multimodal rehabilitation to 1 and 2 years after rehabilitation; (ii) sex differences in sick leave; and (iii) the impact of policy changes on sick leave.
Methods: All patients undergoing multimodal rehabilitation registered in a national pain database for 2007-11 (n=7,297) were linked to the Swedish Social Insurance Agency database. Sick leave was analysed in 3-month periods: T0: 1 year before rehabilitation; T1: before start; T2: 1 year after; and T3: 2 years after rehabilitation. Four sick-leave benefit categories were constructed: no sick leave, part-time sick leave, full-time sick leave, and full-time permanent sick leave. The individual change in sick-leave category at each time-period was analysed.
Results: Sick-leave benefits increased from T0 to T1 (p<0. 001) and decreased from T1 to T3 (p<0. 001). Reductions were significant for both men and women from T1 to T3, but men had less sick-leave benefits at T2 and T3. Positive changes in sick-leave benefits at T2 and T3 were found both prior to and after policy changes, with less sick-leave benefits after policy changes at all time-points.
Conclusion: Multimodal rehabilitation may positively influence sick-leave benefits for patients with chronic pain, regardless of their sick-leave situation, sex or policy changes.

This study investigated changes in sick-leave benefits from 1 year before multimodal rehabilitation to 1 and 2 years after rehabiliation. The study also examined differences in sick leave between men and women, and whether sick-leave policy changes influence patterns of sick leave. All patients receiving pain rehabilitation in 2007–11, who were registered in both the national pain database and the Swedish Social Insurance Agency database, were included in the study. Sick leave was analysed 1 year before rehabilitation, before the start, 1 year after, and 2 years after rehabilitation. It was shown that sick-leave benefits increased during the year before rehabilitation and decreased after rehabilitation. These reductions in benefits were significant for both men and women. Positive changes in sick-leave benefits at follow-up were found both before and after policy changes, with less sick-leave benefits after policy changes at all time-points. In conclusion, multimodal rehabilitation has a positive impact on sick-leave patterns for patients with chronic pain, regardless of their sick-leave situation, sex, or policy changes.