[The positive and negative consequences of sick leave: A systematic review]

Physicians in Sweden devote much time to assessing sickness absence. Despite this, there is a lack of evidence regarding the consequences of sick leave for patients. The last systematic review that attempted to answer this question was conducted in 2003. It identified only five studies, from which no conclusions could be drawn. The aim of this review was to determine what evidence has emerged since then. A PubMed search was conducted for randomized trials and cohort studies that examined the consequences of sick leave in Nordic countries. 36 relevant studies were identified, all of which were cohort studies. All were judged to carry a critical risk of bias. The conclusion is that evidence is still lacking regarding the benefits and harms of sick leave. What is clear, though, is that sick leave is associated with a higher risk of multiple negative outcomes for patients, with patients on sick leave at higher risk of low income, unemployment, suicide, and death.