| Title: |
Changes in sick notes associated with COVID-19 from 2020 to 2022: a cohort study in 24 million primary care patients in OpenSAFELY-TPP. |
| Authors: |
Schaffer, Andrea L; Park, Robin Y; Tazare, John; Bhaskaran, Krishnan; MacKenna, Brian; Denaxas, Spiros; Dillingham, Iain; Bacon, Sebastian CJ; Mehrkar, Amir; Bates, Christopher; Goldacre, Ben; Greaves, Felix; Macleod, John; OpenSAFELY Collaborative; National Core Studies Collaborative; Tomlinson, Laurie A; Walker, Alex |
| Publisher Information: |
BMJ |
| Publication Year: |
2024 |
| Collection: |
London School of Hygiene & Tropical Medicine: LSHTM Research Online |
| Description: |
OBJECTIVES: Long-term sickness absence from employment has negative consequences for the economy and can lead to widened health inequalities. Sick notes (also called 'fit notes') are issued by general practitioners when a person cannot work for health reasons for more than 7 days. We quantified the sick note rate in people with evidence of COVID-19 in 2020, 2021 and 2022, as an indication of the burden for people recovering from COVID-19. DESIGN: Cohort study. SETTING: With National Health Service (NHS) England approval, we used routine clinical data (primary care, hospital and COVID-19 testing records) within the OpenSAFELY-TPP database. PARTICIPANTS: People 18-64 years with a recorded positive test or diagnosis of COVID-19 in 2020 (n=365 421), 2021 (n=1 206 555) or 2022 (n=1 321 313); general population matched in age, sex and region in 2019 (n=3 140 326), 2020 (n=3 439 534), 2021 (n=4 571 469) and 2022 (n=4 818 870); people hospitalised with pneumonia in 2019 (n=29 673). PRIMARY OUTCOME MEASURE: Receipt of a sick note in primary care. RESULTS: Among people with a positive SARS-CoV-2 test or COVID-19 diagnosis, the sick note rate was 4.88 per 100 person-months (95% CI 4.83 to 4.93) in 2020, 2.66 (95% CI 2.64 to 2.67) in 2021 and 1.73 (95% CI 1.72 to 1.73) in 2022. Compared with the age, sex and region-matched general population, the adjusted HR for receipt of a sick note over the entire follow-up period (up to 10 months) was 4.07 (95% CI 4.02 to 4.12) in 2020 decreasing to 1.57 (95% CI 1.56 to 1.58) in 2022. The HR was highest in the first 30 days postdiagnosis in all years. Among people hospitalised with COVID-19, after adjustment, the sick note rate was lower than in people hospitalised with pneumonia. CONCLUSIONS: Given the under-recording of postacute COVID-19-related symptoms, these findings contribute a valuable perspective on the long-term effects of COVID-19. Despite likely underestimation of the sick note rate, sick notes were issued more frequently to people with COVID-19 compared with those without, ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| ISSN: |
2044-6055 |
| Relation: |
https://researchonline.lshtm.ac.uk/id/eprint/4679412/1/Schaffer-etal-2024-Changes-in-sick-notes.pdf; Schaffer, Andrea LORCID logo; Park, Robin Y; Tazare, John ORCID logo; Bhaskaran, Krishnan ORCID logo; MacKenna, Brian; Denaxas, Spiros; Dillingham, Iain; Bacon, Sebastian CJ; Mehrkar, Amir; Bates, Christopher; +7 more.Goldacre, Ben ORCID logo; Greaves, Felix; Macleod, John; OpenSAFELY Collaborative; National Core Studies Collaborative; Tomlinson, Laurie A ORCID logo; and Walker, AlexORCID logo (2024) Changes in sick notes associated with COVID-19 from 2020 to 2022: a cohort study in 24 million primary care patients in OpenSAFELY-TPP. BMJ open, 14 (7). e080600. ISSN 2044-6055 DOI:10.1136/bmjopen-2023-080600 |
| DOI: |
10.1136/bmjopen-2023-080600 |
| Availability: |
https://researchonline.lshtm.ac.uk/id/eprint/4679412/; https://doi.org/10.1136/bmjopen-2023-080600 |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.C4D9048F |
| Database: |
BASE |