"To array a man's will against his sickness is the supreme art of medicine". An analysis of multiple spells of sickness

Abstract

This paper analyzes the long-term sickness absences in Sweden using a longitudinal database that contains all compensated sickness spells for 2,789 persons during 1986-1991. Given the political focus on the improved collaboration between the individual, physician, employer, and social insurance officer, the strategy is to analyze the spells of long-term sickness grouping them by all available factors that concern these actors. The estimates of a mixed proportional hazards model suggest that there was more heterogeneity among spells grouped by the factors related to the health status of the individual and the physician's evaluation than among spells grouped by the factors expected to be related to the social insurance praxis or other sorting processes.