Factors associated with variability in length of sick leave because of acute low back pain in Chile

Abstract 

Background context

Acute low back pain (LBP) is a frequent cause of physician visits and sick leave. Patients with longer sick leave account for most costs associated with LBP. Most research on risk factors for prolonged sick leave because of LBP has been done in Anglo-Saxon or Northern European populations with occupational LBP. Few studies have been conducted in less affluent Latin countries.

Purpose

To investigate the prevalence of acute LBP as a cause of sick leave and the variables associated with longer work absence (WA) because of acute LBP in Chile.

Study design

A retrospective study of nonoccupational sick leave certificates issued in a 1-year period by the Chilean Public Health System.

Patient sample

Ten thousand cases with nonoccupational sick leave certificates issued with the diagnosis of acute LBP.

Outcome measures

Prevalence of acute LBP as a cause of sick leave, days of WA, and subsidy payment.

Methods

A review of sick leave certificates from patients with different diagnoses was done to determine the prevalence of acute LBP as a cause of sick leave. We investigated whether age, gender, history of at least one episode of sick leave in the previous year because of acute LBP or because of other diagnoses, stipendiary subsidy paid (converted to US $), work activity, occupation, and the specialty of the attending physician influenced the length of sick leave.

Results

Acute LBP represented 5.4% of cases causing sick leave. Patients with acute LBP who had significantly longer sick leave than the rest of the population were patients with an episode of WA because of LBP in the previous year (14% longer sick leave than patients without that history), manual workers (35% longer than nonmanual workers), and patients seen by orthopedic surgeons (43% longer than patients seen by other medical specialists). Nonpregnant women and men had similar durations of sick leave because of acute LBP.

Conclusions

Physicians who treat patients with LBP should be aware of these variables associated with longer sick leave because of acute LBP, which represents a significant burden to any society and is an important epidemiologic problem.

Keywords: Low back pain, Sick leave, Prevalence, Cost of Illness, Absenteeism