Confidence in public institutions: A focus group study on views on the Swedish Social Insurance Agency.

BACKGROUND: From a public health perspective among the working population, it is very important that confidence in the welfare system is high, ensuring the citizens economic security and protecting them from economic stress when falling ill. OBJECTIVE: The aim of this study was to explore how people with experience of health insurance perceive their confidence in the Swedish Social Insurance Agency (SSIA). METHODS: Eight focus groups (n = 41) were conducted and each group met on one occasion. RESULTS: The participants described a systemic change in the work of the SSIA where the rule-of-law was disregarded, with arbitrary assessment, and no transparency. The reception by the SSIA shaped the image of the SSIA. The participants described vulnerability in relation to the SSIA. They felt mistrusted, which left a feeling of impotence that worsened their health. Experiencing vulnerability left a strong impression and affected the participants' confidence negatively. CONCLUSIONS: The following has to be acknowledged to prevent clients from experiencing impaired health, promote return-to-work possibilities, and to push public confidence in the institution in a more positive direction: Politicians and public administrators need to clarify the regulations. The decision-making process needs to be transparent and just. The entire procedure, including continuity as well as a personal, nice reception, has to be ensured.

Strong support for relocation to other work tasks: A cross-sectional study of attitudes to sickness insurance regulations in Sweden.

BACKGROUND: Profound changes are taking place in the Swedish welfare state. The general population's attitudes are important insofar changes will be perceived as fair and effective to become implemented. OBJECTIVE: The aim was to study attitudes to the strictness of the sick-leave rules, relocation to other work tasks after 3 months of sick leave and applications for new jobs after 6 months of sick leave. METHODS: Eligible for this questionnaire study were 1,140 individuals aged 19 to 64 years. Their attitudes were analyzed in relation to age, gender, political ideology and health status. Health status was measured as sick-leave experiences, self-reported health and level of symptoms. RESULTS: Showed that 42% considered the sick-leave rules to be too strict, 60% found relocation to other work tasks to be good while 35% found that applications for new work were good. In logistic regression analyses, high sick-leave experience was associated with increased odds of finding the sick-leave rules too strict and disagreement with relocation to other work tasks or application for new jobs. CONCLUSIONS: In conclusion, strong support was found for relocation to other work tasks with the present employer. Earlier research on returning to work has found workplace interventions to be efficient. From a policy perspective it seems relevant to promote such interventions given the strong public opinion in their favor.