Occupational Medicine Advance Access first published online on January 22, 2008
This version published online on January 24, 2008
Occupational Medicine, doi:10.1093/occmed/kqm141
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Predicting job loss in those off sick
1 Division of Community Based Sciences, Faculty of Medicine, Public Health and Health Policy Section, University of Glasgow, Glasgow, UK
2 Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
3 Section of Public Health, School of Health and Related Research, University of Sheffield, Sheffield, UK
4 School of Health and Related Research, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
5 Physiotherapy Services, Sheffield PCT, Fulwood House, Fulwood Road, Sheffield S10 3TH, UK
Background Evidence shows incapacity benefit claimants (those off sick >26 weeks) are at greatest risk of long-term job loss.
Aim To develop a screening tool to select those at risk of job loss, defined as failure to return to work among those off sick. The screening tool was for use in the Job Retention and Rehabilitation Pilot of the Department for Work and Pensions.
Methods A literature review identified risks for long-term incapacity and job loss as multifactorial [1]. Potential predictors for return to work were then assembled into a set of questions and tested by a prospective study in general practice surgeries and a retrospective study of occupational health records of local authority employees referred for sickness absence management, using univariate and multivariate logistic regression analysis.
Results Univariate logistic regression analysis of the retrospective study produced odds ratios with 95% confidence intervals for each question (where P 
0.05) and a C-index was then constructed for their predictive power. Five questions holding the greatest predictive power were subjected to multivariate analysis and in the final model had a high C-index of 0.90 (0.5 = no predictive power, 1.0 = perfect prediction). They formed the screening tool. The questions cover self-assessment of ability to return to work after current sick leave, of ability to do current job in 6 months' time, sick leave in past year, current age and whether awaiting a consultation or treatment.
Conclusion A screening tool identifying those most at risk of job loss has been produced.
Keywords Barriers to return to work; risk factors for job loss; sickness absence >6 weeks
Correspondence to: Ewan B. Macdonald, Division of Community Based Sciences, Faculty of Medicine, Public Health and Health Policy Section, University of Glasgow, Glasgow, UK. Tel: +141 330 3719; fax: +141 330 4038; e-mail: e.b.macdonald{at}clinmed.gla.ac.uk.