Erratum: Leino-Arjas et al. Process of Work Disability: From Determinants of Sickness Absence Trajectories to Disability Retirement in a Long-Term Follow-Up of Municipal Employees. Int. J. Environ. Res. Public Health 2021, 18, 2614

The authors wish to make the following correction to this paper [...]

Changes in Unemployment Affect Sickness Absence and Disability Retirement Rates: A Municipality-Level Panel Study

To enhance understanding of the interplay between unemployment and sickness absence and disability retirement, the aim of this study was to examine how changes in area-level unemployment rates are associated with changes in sickness absence and disability retirement rates in a longitudinal setting. Municipality-level time-series data were collected on unemployment, sickness absence, disability retirement and covariates from databases for Finnish municipalities for years 2003–2017 (n = 4425 municipality–year observations). Fixed effects panel regression models were used to analyse how changes in unemployment rates predict changes in sickness absence and disability retirement rates when comparing consecutive years. The results showed that when examining yearly cross-sections, a higher level of unemployment in the municipality was associated with higher sickness absence and disability retirement rates. However, longitudinal assessment of consecutive years with panel regression models showed that a one percentage point increase in the municipality-level unemployment rate was associated with a decrease both in the sickness absence rate (−1.3%, p < 0.001) and in the disability retirement rate (−2.1%, p = 0.011), adjusted for simultaneous changes in demographic and socio-economic covariates, morbidity and economic situation of the municipality. The results indicate that unemployment and disability benefits partly act as substitutes for each other. Unemployment and disability rates should be assessed together to reach a more complete understanding of the level of non-employment overall and in different areas.

Work Resumption after a Fixed-Term Disability Pension: Changes over Time during a Period of Decreasing Incidence of Disability Retirement

The incidence of disability retirement in Finland has sharply decreased over the last ten years. At the same time, the share of fixed-term pensions has increased to cover more than half of all new disability pensions. This study examined the efficiency of fixed-term disability pensions under these changing circumstances with the aim of addressing the following research questions: are fixed-term disability pensions more often converted to permanent pensions, and how have the changes affected return to work? The study was based on register data of Finnish residents aged 25–62 whose fixed-term disability pension started in 2006 (n = 10,177) or 2015 (n = 7918). Of the fixed-term disability pensions starting in 2006, 58 percent were converted to a permanent disability pension within the next four years. In 2015, the corresponding figure was 41 percent. Return to work increased from 24 to 30 percent. In addition, ending up in some other state (most often unemployment) increased, and, more often, fixed-term disability pensions continued for more than four years. Transferring to a permanent disability pension decreased more among the younger, those with a lower education, and those suffering from mental disorders. The results were not notably affected by changes in the characteristics of fixed-term disability pension recipients (e.g., demographic and occupational characteristics and rehabilitation) or the selection of applicants into a fixed-term or a permanent pension. Return to work increased more among men, the older age groups, those with a fixed-term disability pension due to somatic diseases, and those who had received vocational rehabilitation. Adjusting for the composition of fixed-term disability pensioners increased the differences between the study years, and controlling for the selection into a fixed-term pension further widened the differences. In conclusion, a decreasing proportion of fixed-term disability pensions are converted to permanent pensions, but this is only partly reflected in increased return to work. Further efforts are needed to support work resumption after a fixed-term disability pension to avoid the situation where people drop out from disability pension but are resting on unemployment and other benefits.

‘Return to Work’ Coordinator Model and Work Participation of Employees: A Natural Intervention Study in Finland

Purpose Employers increasingly use ‘return to work’ (RTW) coordinators to support work ability and extend working careers, particularly among employees with reduced work ability. We examined whether applying this model was associated with changes in employee sickness absence and disability retirements. Methods We used data from the Finnish Public Sector study from 2009 until 2015. Employees where the model was introduced in 2012 constituted the cases (n = 4120, one municipality) and employees where the model was not in use during the follow-up, represented the controls (n = 5600, two municipalities). We analysed risk of disability retirement in 2013–2015 and risk of sickness absence after (2013–2015) vs. before (2009–2011) intervention by case–control status. Results The incidence of disability retirement after the intervention was lower in cases compared to controls both in the total population (hazard ratio HR = 0.49, 95% CI 0.30–0.79) and in the subgroup of participants with reduced work ability (HR = 0.34, 95% CI 0.12–0.99). The risk of sickness absence increased from pre-intervention to post-intervention period both among cases and controls although the relative increase was greater among cases (RRpost- vs. pre-intervention = 1.26, 95% CI 1.14–1.40) than controls (RRpost- vs. pre-intervention = 1.03, 95% CI 0.97–1.08). In the group of employees with reduced work ability, no difference in sickness absence trends between cases and controls was observed. Conclusions These findings suggest that RTW-coordinator model may increase employee sickness absence, but decrease the risk of disability retirement, i.e., permanent exclusion from the labour market.

Työkyvyttömyyseläkkeelle siirtymisen erot kunta-alan ja yksityisen sektorin palkansaajilla

Tässä tutkimuksessa selvitettiin kunta-alan ja yksityisen sektorin palkansaajien välisiä eroja työkyvyttömyyseläkealkavuuksissa ja sitä, miten yksilötason tekijät ovat yhteydessä näihin eroihin. Täydelle työkyvyttömyyseläkkeelle ja osatyökyvyttömyyseläkkeelle siirtymistä tarkasteltiin erikseen. Tarkasteluissa otettiin huomioon myös työkyvyttömyyden syy ja se, onko työkyvyttömyyseläke alkanut kuntoutustukena vai jatkuvana. Lisäksi otettiin huomioon työnantajan koko. Aineistona oli Eläketurvakeskuksen rekisteriaineisto (kokonaisotos), johon on liitetty tietoja Tilastokeskuksesta ja Digi- ja väestötietovirastosta. Tarkastelun kohteena oli ei-eläkkeellä oleva 30–62-vuotias työeläkevakuutettu väestö vuonna 2013. Työkyvyttömyyseläkkeelle siirtymistä mallinnettiin vuosien 2014–2017 tiedoilla käyttäen Coxin suhteellisten vaarojen mallia ja logistista regressioanalyysiä. Tulokset osoittavat, että kunta-alan ja yksityisen sektorin väliset erot työkyvyttömyyseläkkeelle siirtymisessä ovat suuremmat osatyökyvyttömyyseläkkeissä kuin täysissä työkyvyttömyyseläkkeissä. Työkyvyttömyyseläkkeelle siirtyminen on myös yleisempää suuremmilla kuin pienemmillä työnantajilla. Tämä näkyy erityisesti osatyökyvyttömyyseläkkeiden osalta. Havaitut erot kunta-alan ja yksityisen sektorin palkansaajien välillä osatyökyvyttömyyseläkealkavuuksissa pienenevät, kun yksilötason tekijät otetaan huomioon. Kunta-alalta siirrytään selkeästi useammin osatyökyvyttömyyseläkkeelle kuin yksityiseltä sektorilta. Yksilötason tekijöiden vakiointi pienentää jonkin verran kunta-alan ja yksityisen sektorin työntekijöiden välisiä havaittuja eroja osatyökyvyttömyyseläkealkavuudessa. Abstract Differences in disability retirement between municipal and private sector employees This study examines the differences in disability retirement between municipal and private sector employees and how individual-level factors associate with these differences. Disability retirement on a full and partial pension is studied separately. Differences are also studied by the cause of disability, which is the basis for a pension being granted temporarily or until further notice. In addition, the importance of company size is taken into account. Register data (100 per cent sample of Finns) from the Finnish Centre for Pensions, which include information from Statistics Finland and the Digital and Population Data Services Agency, are used. Analysis is restricted to the non-retired pension-insured population aged 30–62 in 2013. The Cox Proportional Hazard Model and logistic regression analysis are used to analyze disability retirement between 2014 and 2017. The results show that differences in disability retirement between the private and municipal sector employees were greater among those who retired on a partial disability pension than those who retired on a full disability pension. In particular, partial disability retirement was more common in larger than in smaller companies. Differences in partial disability retirement between the municipal and private sector employees were reduced after controlling for all individual-level factors. Disability retirement is more common in the municipal sector than for private sector employees. Differences are particularly large among those who retire on a partial disability pension. Adjustment of individual-level factors reduces the differences in disability retirement between private and municipal sector employees. Keywords: municipal sector, private sector, disability retirement, partial disability pension, full disability pension, temporary pension.

Pengalaman Perawat dalam Menghadapi Masa Persiapan Pensiun di RS Bhayangkara Denpasar

Retirement is a separation from employment whereby an employee opts to cease working due to age or disability. Retirement preparation is a set of plan for employees to adapt to some challenges for their retirement. This study aimed at analyzing nurses’ experiences towards retirement preparation. To accomplish this goal, this study used a descriptive qualitative design which was descriptive phenomenological approach. This study was conducted in 2019 in Bhayangkara Hospital Denpasar. The sample of this study was 4 participants. The technique used was purposive sampling. The data were collected through in-depth interview and field notes. The obtained data were analyzing through colaizi method. The results of this study were 4 themes such as, 1. nurses’ understanding towards retirement preparation, 2. nurses’ feelings towards retirement preparation, 3. the challenges faced by nurses towards retirement preparation, 4. ways to cope with challenges of retirement preparation. Researcher expectations For nurses who will retire can improve the ability and service of nurses in dealing with problems experienced by clients