Prediction of future labour market outcome in a cohort of long-term sick-listed Danes

TY - JOUR

T1 - Prediction of future labour market outcome in a cohort of long-term sick-listed Danes

AU - Pedersen, Jacob

AU - Gerds, Thomas Alexander

AU - Bjørner, Jakob

AU - Christensen, Karl Bang

PY - 2014/5/23

Y1 - 2014/5/23

N2 - BACKGROUND: Targeted interventions for the long-term sick-listed may prevent permanent exclusion from the labour force. We aimed to develop a prediction method for identifying high risk groups for continued or recurrent long-term sickness absence, unemployment, or disability among persons on long-term sick leave.METHODS: We obtained individual characteristics and follow-up data from the Danish Register of Sickness Absence Compensation Benefits and Social Transfer Payments (RSS) during 2004 to 2010 for 189,279 Danes who experienced a period of long-term sickness absence (4+ weeks). In a learning data set, statistical prediction methods were built using logistic regression and a discrete event simulation approach for a one year prediction horizon. Personalized risk profiles were obtained for five outcomes: employment, unemployment, recurrent sickness absence, continuous long-term sickness absence, and early retirement from the labour market. Predictor variables included gender, age, socio-economic position, job type, chronic disease status, history of sickness absence, and prior history of unemployment. Separate models were built for times of economic growth (2005-2007) and times of recession (2008-2010). The accuracy of the prediction models was assessed with analyses of Receiver Operating Characteristic (ROC) curves and the Brier score in an independent validation data set.RESULTS: In comparison with a null model which ignored the predictor variables, logistic regression achieved only moderate prediction accuracy for the five outcome states. Results obtained with discrete event simulation were comparable with logistic regression.CONCLUSIONS: Only moderate prediction accuracy could be achieved using the selected information from the Danish register RSS. Other variables need to be included in order to establish a prediction method which provides more accurate risk profiles for long-term sick-listed persons.

AB - BACKGROUND: Targeted interventions for the long-term sick-listed may prevent permanent exclusion from the labour force. We aimed to develop a prediction method for identifying high risk groups for continued or recurrent long-term sickness absence, unemployment, or disability among persons on long-term sick leave.METHODS: We obtained individual characteristics and follow-up data from the Danish Register of Sickness Absence Compensation Benefits and Social Transfer Payments (RSS) during 2004 to 2010 for 189,279 Danes who experienced a period of long-term sickness absence (4+ weeks). In a learning data set, statistical prediction methods were built using logistic regression and a discrete event simulation approach for a one year prediction horizon. Personalized risk profiles were obtained for five outcomes: employment, unemployment, recurrent sickness absence, continuous long-term sickness absence, and early retirement from the labour market. Predictor variables included gender, age, socio-economic position, job type, chronic disease status, history of sickness absence, and prior history of unemployment. Separate models were built for times of economic growth (2005-2007) and times of recession (2008-2010). The accuracy of the prediction models was assessed with analyses of Receiver Operating Characteristic (ROC) curves and the Brier score in an independent validation data set.RESULTS: In comparison with a null model which ignored the predictor variables, logistic regression achieved only moderate prediction accuracy for the five outcome states. Results obtained with discrete event simulation were comparable with logistic regression.CONCLUSIONS: Only moderate prediction accuracy could be achieved using the selected information from the Danish register RSS. Other variables need to be included in order to establish a prediction method which provides more accurate risk profiles for long-term sick-listed persons.

U2 - 10.1186/1471-2458-14-494

DO - 10.1186/1471-2458-14-494

M3 - Journal article

C2 - 24885866

SN - 1471-2458

VL - 14

SP - 1

EP - 11

JO - BMC Public Health

JF - BMC Public Health

M1 - 494

ER -