Predictive validity of general work ability assessments in the context of sickness insurance

Abstract

Objective: The activity ability assessment is a Swedish method for assessing general work ability, based on self-reports combined with an examination by specially trained physicians, and, if needed, extended assessments by occupational therapists, physiotherapists and/or psychologists. The aim of this study was to analyse the predictive validity of the activity ability assessment in relation to future sick leave. Design: Analysis of assessments in 300 case files, in relation to register data on sick leave. Subjects: People on sick leave (n =300, 32% men, 68% women; mean age 48 years; assessment at mean sick leave day 249). Methods: Univariate and multivariate statistics. Results: Self-rated work ability was the only factor with predictive value related to future sick leave. Physicians’ evaluations lacked predictive value, except where the person had a limitation in vision, hearing or speech that was predictive of future decisions by the Social Insurance Agency. No sex differences were identified. Conclusion: The predictive value of the activity ability assessment for future sick leave is limited, and self-rated work ability is more accurate compared with an extensive insurance medical assessment. Self-rated work ability may be more holistic compared with insurance medicine assessments, which may be overly focused on individual factors. A practical implication of this is that the inclusion of contextual factors in assessment procedures needs to be improved.

Keywords

• social security
• sick leave
• return to work