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AN ANALYSIS OF LONG-TERM SICK LEAVE IN SLOVENIA

This analysis examines long-term sick leave trends and reasons in Slovenia, highlighting the need for legal limitations and professional rehabilitation in the return-to-work process.

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AN ANALYSIS OF LONG-TERM SICK LEAVE IN SLOVENIA

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  1. AN ANALYSIS OF LONG-TERM SICK LEAVE IN SLOVENIA dr. TicijanaPrijon, dr.med., dr. Tomaž Čakš, dr.med. HealthInsurance Institut ofSlovenia Prijon, Čakš - Long Term Sick Leave

  2. Both authors declare no conflicts of interest. Prijon, Čakš - Long Term Sick Leave

  3. Introduction • Sick leave is a temporary absence from work due to illness, injury, treatment and other reasons. • Absenteeism does not come exclusively from the health status of an employee, but is also the consequence of work, social, economic and other factors. • Absenteeism is an important indicator of health status of workers, therefore regular monitoring of absenteeism is a prerequisite for its management. Prijon, Čakš - Long Term Sick Leave

  4. The justification for temporary incapacity for work of insured persons longer than 30 days is granted by selected physicians from ZZZS (Health Insurance Institute of Slovenia) upon the proposal by the patient's selected physician. • On ZZZS (Health Insurance Institute) we are obliged to refer patients to the Invalidity Committee on ZPIZ (Pension and Disability Insurance Institute), if we estimate that there is no improvement in the state of health, which would also enable him/her to recover his/her working ability. • We are obliged to do so even if the insured is detained from work due to illness or injury for a continuous period of one year. Prijon, Čakš - Long Term Sick Leave

  5. Slovenia has no legally prescribed limit for temporary incapacity for work. • Long-time absentees are a social problem from health, economic, welfare and other perspectives. • The numbers of long-term absentees have been increasing in the last years. Prijon, Čakš - Long Term Sick Leave

  6. Among possible reasonsfor the increase in absenteeism: • Increase in the number of employed persons, • the ageing of workforce, • consequently higher morbidity of active workforce, • presenteeism in the past years of economic crisis, • longer procedures for medical diagnostics and treatment, • etc. Prijon, Čakš - Long Term Sick Leave

  7. Methods • retrospective analysis of long-term absenteeism, with special focus on temporary incapacity for work of insured persons, lasting more than 3 years. Prijon, Čakš - Long Term Sick Leave

  8. Results On 30 September 2017: • 899 persons (477 men and 422 women) on sick leave more than 3 years (4.17% of all absentees) • Numbers increased proportionately with age. Prijon, Čakš - Long Term Sick Leave

  9. Trend of movement of the number of LTSL over 3 yearsfrom 2013 on Prijon, Čakš - Long Term Sick Leave

  10. Trend of movement of the number of LTSL over 5 yearsfrom 2013 on Prijon, Čakš - Long Term Sick Leave

  11. Number of LTSCsover 3 years by age groups and sex LTSC over 3 years: 53,1% M, 46,9% F; LTSC over 5 years: 64,6% M, 35,4% F Prijon, Čakš - Long Term Sick Leave

  12. The most common reason for long-term absence in Slovenia: • illness (82.3%), • injury outside work (8.9%) • work injuries (5.6%). Prijon, Čakš - Long Term Sick Leave

  13. The most common reasons for long-term absence in men in Slovenia: • diseases of musculoskeletal system and connective tissues (30.1%), • recovery after injury or poisoning (28.6%), • neoplasms (8.9%), • circulatory diseases (8.9%) Prijon, Čakš - Long Term Sick Leave

  14. The most common reasons for long-term absence in women in Slovenia: • diseases of musculoskeletal system and connective tissues (35.1%), • neoplasms (16.9%), • recovery after injury or poisoning (15.3%), • mental and behavioural conditions (10.5%), • neuromuscular diseases (5.6%). Prijon, Čakš - Long Term Sick Leave

  15. DILEMMAS OF THE MAIN STAKEHOLDERS IN THE RETURN-TO-WORK PROCESS Stakeholders are: • vocational rehabilitation (VR) providers, • employers • national insurance institutions. • The most important issue of VR provider teams is the variety of professions included • Employer’s activities in the return-to-work process are influenced by economical, legislative and ethical factors, whereby economic factors take priority. • Public institutions have their own ethical principles – they are client-oriented but have to strictly follow the rules and regulations. • Theensuing gap leads to ethical dilemmas. • collaboration of all stakeholders is crucial in vocational rehabilitation. Source: Teržan M. Ethics in vocational rehabilitation . Rehabilitation (Ljubljana)letn. XVII, supl. 1, 2016: 143-147 Prijon, Čakš - Long Term Sick Leave

  16. Conclusions • With respect to the relatively low influence of selected physicians on the number of absentees, a long term solution to the long-term absenteeism is possible only with legal limitation of its duration, as is the case in most of the EU membersandtheintroductionofprofessionalrehabilitationandreturn-to-work. • In professionalrehabilitation, weshouldfocus on the most commondiseases, as stated in theresultsofouranalysis. • The introduction of professional rehabilitation and return-to-work should have wider support. Prijon, Čakš - Long Term Sick Leave

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