The Ministry of Health of Latvia (VM) has concluded that making diagnosis codes mandatory on sick leave certificates would currently not be the most effective way to obtain information about the most common causes of work incapacity.
To improve data collection, the ministry evaluated four different approaches to obtaining and linking data. These included mandatory diagnosis codes on sick leave forms, analysing free-text fields on sick leave certificates, and manually matching sick leave records with outpatient visit data from the National Health Service of Latvia management information system.
Another option assessed was a self-service reporting tool, which would allow trained users to generate anonymised reports and reduce the need for manual data extraction. The tool will be developed as part of the Recovery and Resilience Facility project “Improvement of Healthcare Process Data Management.”
The ministry notes that the system is currently in a transitional phase. In the short term, manual data matching is being used to obtain initial signals about trends. The planned
project aims to enable repeatable reports and systematic data integration with built-in quality control mechanisms.
VM concluded that introducing mandatory diagnosis codes now would not be optimal without a user-friendly interface, guidelines and feedback mechanisms. According to the ministry, such a requirement could lead to “formal coding” practices and increase the administrative burden on doctors. It would also not solve data compatibility issues with other information sources and would require additional funding.
The ministry also found that analysing free-text fields provides only preliminary insights. These fields are filled in for about 2% of entries, and the information recorded is unstructured, making it unsuitable for broader statistical analysis.
To gain an initial understanding of the causes of sick leave, the ministry manually linked sick leave records with outpatient visit data for 2024. This approach allowed about 72% of sick leave certificates to be matched with relevant medical data.
The combined data show that upper respiratory infections are the most common cause of short-term sick leave,
accounting for roughly 30–40% of cases, typically lasting up to nine days.
Meanwhile, musculoskeletal disorders are more often associated with longer sick leave periods. For example, the spondylosis diagnosis group accounted for around 10% of cases in the analysed data.
The ministry notes that these trends highlight the importance of workplace prevention measures and infection control, as well as the impact of ergonomics, workload and work organisation on musculoskeletal health.
At the same time, the ministry emphasises that linking datasets does not necessarily mean the outpatient diagnosis was the direct cause of the sick leave certificate. Patients may have multiple illnesses simultaneously, and healthcare episodes may overlap. Results are also sensitive to the chosen time interval between outpatient visits and sick leave periods. Additionally, outpatient data do not fully cover private medical practices.
The ministry plans to cooperate with the Central Statistical Bureau of Latvia (CSP) to include information on industries, professions and other socio-demographic factors in the analysis. This would help identify risk groups, target prevention measures and better understand factors affecting work incapacity.
In the long term,
integration of CSP data is planned to provide a more comprehensive picture of illnesses among employed persons
and their absence from work. This integration is expected to begin in the second half of 2027.
The ministry outlined these conclusions in an informational report currently submitted for consultation. Comments and proposals may be submitted until the 20th of March.
Earlier reports indicated that the government reviewed a VM report in August last year proposing more precise diagnosis reporting on sick leave certificates. Ministry data show that in 2024 about 80.4% of sick leave certificates were classified under “other cause,” because indicating a specific diagnosis is not mandatory, making it difficult to determine the most common reasons for sick leave.
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