Changes In Absenteeism Research Articles

Investigating the Effectiveness of a Workplace Musculoskeletal Disorders Management Program.

Musculoskeletal disorders (MSDs) present a major occupational health challenge, especially among office workers. Objective: To evaluate the effectiveness of a workplace intervention program for managing MSDs and measure its impact on presenteeism/absenteeism and health status. Methods: This semi-experimental study was conducted between May 2019 and October 2022 in Greece and involved 247 office workers randomly assigned to early and late intervention groups. The intervention included a seminar on ergonomics and proper workstation practices with a demonstration of exercises. Data were collected by the SF-36, the Standardised Nordic, and the Work Productivity and Activity Impairment Questionnaires. Results: In the early intervention group (n = 143), presenteeism significantly decreased (p = 0.045), from a mean value of 0.11 to 0.07, but not absenteeism. Significant improvements were observed in physical (p = 0.007) and mental health (p = 0.012). Reductions in pain were recorded for the neck (p = 0.032), shoulders (p = 0.015), wrists (p = 0.014), upper back, lower back, hips, and knees (p = 0.044 for each). In the late intervention group (n=104), there were no significant changes in absenteeism or presenteeism. Mental health improved significantly (p = 0.008), and reductions in pain were noted for the neck (p = 0.001), wrist (p = 0.0005), and upper back (p = 0.001). Conclusions: This workplace intervention program proved effective both in reducing pain in various body areas and reducing presenteeism, and improved physical and mental health were observed in the intervention groups while absenteeism remained unchanged.

Effect of a Comprehensive School-Based Health Center on Academic Growth in K-8th Grade Students

ObjectiveSchool-based health centers (SBHCs) improve health care access, but associations with educational outcomes are mixed and limited for elementary and middle school students. We investigated whether students enrolled in a comprehensive SBHC demonstrated more growth in standardized math and reading assessments over 4 school years versus nonenrolled students. We also explored changes in absenteeism. MethodsParticipants were students enrolled in 2 co-located Title I schools from 2015–19 (1 elementary, 1 middle, n = 2480). Analysis of math and reading was limited to students with baseline and postbaseline scores (math n = 1622; reading n = 1607). Longitudinal regression models accounting for within-subject clustering were used to estimate the association of SBHC enrollment with academic scores and daily absenteeism, adjusting for grade, sex, body mass index category, health conditions, baseline outcomes (scores or absenteeism), and outcome pretrends. ResultsMore than 70% of SBHC-enrolled students had math (1194 [73.6%]) and reading 1186 [73.8%]) scores. Enrollees were more likely than nonenrollees to have asthma (39.7% vs 19.6%) and overweight/obesity (42.4% vs 33.6%). Adjusted baseline scores were significantly lower in math and reading for enrollees. Mean change from baseline for enrollees exceeded nonenrollees by 3.5 points (95% confidence interval [CI]: 2.2, 4.8) in math and 2.1 points (95% CI: 0.9, 3.3) in reading. The adjusted rate of decrease in daily absenteeism was 10.8% greater for enrollees (incident rate ratio 0.772 [95% CI: 0.623, 0.956]) than nonenrollees (incident rate ratio 0.865 [95% CI: 0.696, 1.076]). ConclusionsSBHC enrollees had greater health and educational risk but demonstrated more growth in math and reading and less absenteeism than nonenrollees.

Changes in the menstrual hygiene management facilities and usage among Bangladeshi school girls and its effect on school absenteeism from 2014 to 2018

ABSTRACT Background The lack of menstrual hygiene management (MHM) information and facilities in schools is a major contributor to adolescent girls’ school absenteeism in low- and middle-income countries like Bangladesh. Objectives This paper examines the changes over time in school MHM facilities, knowledge and perceptions among adolescent girls, in relation to school absenteeism between 2014 and 2018 in Bangladesh. Methods We examined changes in MHM and school absenteeism among schoolgirls using nationally representative data from the Bangladesh National Hygiene Baseline Survey 2014 and National Hygiene Survey 2018. Given the repetitive nature of our data and its clustering within participants, our method included performing descriptive analysis, bivariate analysis, and multivariate Generalised Estimating Equation (GEE) modelling to analyse these changes. Results Results showed that adolescent girls’ menstruation-related absenteeism decreased between 2014 and 2018. Percentage of adolescents who missed school decreased from 25% to 14% (PD: −11; CI: −16 to −6.1), while the average number of missed days reduced from 2.8 to 2.5 (PD: −0.33; CI: −0.57 to −0.10). In the GEE model, we found that living in rural areas (coef: −5.6; CI: −10.06 to −1.14), parental restrictions on going outside (coef: 4.47; CI: 0.75 to 8.2), education levels of girls (coef: −9.48; CI: −14.17 to −4.79), girl’s belief that menstruation affects school performance (coef: 23.32; CI: 19.71 to 26.93), and using old cloths (coef: −4.2; CI: −7.6 to −0.79) were significantly associated with higher absenteeism. However, participant’s age, type of school, knowledge of menstruation before menarche, receiving information regarding MHM, separate place for changing absorbents, and separate latrine and urine facility were not significantly associated with the changes in absenteeism over time. Conclusion This paper emphasised the associations between changes in school absenteeism, parental restrictions on students, students’ education levels, and menstruation-related misperceptions. Ongoing research, policy reviews, and targeted interventions to improve MHM perceptions among girls are required to provide long-term benefits for adolescent girls in Bangladesh.

0861 Does Cognitive Behavioral Therapy for Insomnia Reduce Productivity Loss in Cancer Survivors with Cognitive Impairment?

Abstract Introduction Insomnia and perceived cognitive impairments (PCI) affect 1 in 4 cancer survivors and negatively affects work productivity. This study explores the impact of cognitive behavioral therapy for insomnia (CBT-I) on work presenteeism and absenteeism in cancer survivors with comorbid insomnia and PCI. Methods A sub-sample of 42 Atlantic Canadian survivors with insomnia disorder and PCI who were currently working for pay were analyzed as part of a larger randomized clinical trial. Participants completed 7 virtual sessions of CBT-I. The Work Productivity and Activity Impairment Index Specific Health Problem Questionnaire (WPAI: SHP) was administered pre-and post-treatment. Absenteeism was defined as the percentage of time absent from work, while presenteeism was defined as the extent to which health problems affected productivity at work in the past 7 days. Costs were calculated by the human capital method. Significant changes in productivity loss were defined at ≥15% or 20% change in absenteeism and presenteeism, respectively. Descriptive statistics and paired samples t-tests were used to measure changes in productivity following treatment. Average net benefit was calculated by subtracting the average treatment cost from average treatment benefits after 1 year to reflect cost savings after CBT-I. The cost of treatment was estimated in terms of average cost per session and lost time at work. Results Participants (76% Female) were, on average, 50.4 years old with 16.6 years of education. Breast cancer was the most reported cancer type (43%). Overall rates of presenteeism were significantly lower at post-treatment (p=<.001, d=0.55), with 52.4% reporting significant reductions. Absenteeism rates from pre- to post-treatment were not significant (p=.11, d=0.20). Reduced productivity loss post-treatment was associated with an average savings of CAD$10,979/person/year. Average net benefits for the first-year post-treatment equaled CAD$9348/person. Conclusion CBT-I can improve work productivity in cancer survivors. Investments to increase and provide access to evidence-based treatment may lead to significant savings for individuals and businesses. Support (if any) Dr. Sheila Garland is supported by a Canadian Cancer Society Emerging Scholar Award (Survivorship) (grant #707146). This project was funded through a grant from the Canadian Institutes of Health Research (CIHR) (grant number: PJT 162428) and the Beatrice Hunter Cancer Research Institute.

Predicting and explaining absenteeism risk in hospital patients before and during COVID-19

In order to address one of the most challenging problems in hospital management – patients’ absenteeism without prior notice – this study analyses the risk factors associated with this event. To this end, through real data from a hospital located in the North of Portugal, a prediction model previously validated in the literature is used to infer absenteeism risk factors, and an explainable model is proposed, based on a modified CART algorithm. The latter intends to generate a human-interpretable explanation for patient absenteeism, and its implementation is described in detail. Furthermore, given the significant impact, the COVID-19 pandemic had on hospital management, a comparison between patients’ profiles upon absenteeism before and during the COVID-19 pandemic situation is performed. Results obtained differ between hospital specialities and time periods meaning that patient profiles on absenteeism change during pandemic periods and within specialities.

The Indirect Effects of a Mindfulness Mobile App on Productivity Through Changes in Sleep Among Retail Employees: Secondary Analysis.

BackgroundChronic sleep disturbance is prevalent among United States employees and associated with costly productivity impairment. Mindfulness interventions improve sleep (ie, insomnia and daytime sleepiness) and productivity outcomes, and mobile apps provide scalable means of intervention delivery. However, few studies have examined the effects of mindfulness mobile apps on employees, and no research to date has tested the role of sleep improvement as a potential mechanism of action for productivity outcomes.ObjectiveThis study examined the effects of Calm, a consumer-based mindfulness app, and sleep coaching, on productivity impairment among retail employees through the indirect effects of changes in insomnia and daytime sleepiness.MethodsThis study was a secondary analysis of data from a randomized controlled trial (N=1029) comparing the use of Calm (n=585, 56.9%) to a waitlist control (n=444, 43.2%) for 8 weeks among employees of a large retail employer in the United States. A subset of individuals with elevated insomnia symptoms also had access to brief sleep coaching with Calm (n=101, 9.8%). Insomnia symptom severity, daytime sleepiness, and productivity impairment (ie, absenteeism, presenteeism, overall productivity impairment, and non–work activity impairment) were assessed at baseline and weeks 2, 4, 6, and 8. Indirect effects were evaluated with latent growth curve modeling to test whether the Calm intervention (Calm group vs waitlist control) was effective in reducing work productivity impairment through changes in sleep disturbance.ResultsNo significant main effects of Calm intervention on productivity impairment were detected for any outcome at α level of .05, with the exception of non–work activity impairment models, in which Calm intervention reduced non–work activity impairment over time (P=.01 and P=.02 for insomnia and sleepiness models, respectively). Significant indirect effects of insomnia were detected for presenteeism (P=.002), overall work productivity (P=.01), and non–work activity impairment (P=.002); Calm intervention produced significantly greater reductions in insomnia symptoms (relative to waitlist control), and decreases in insomnia were associated with decreases in work productivity impairment. There was no significant indirect effect of change in insomnia on changes in absenteeism (P=.20). Furthermore, we detected no significant indirect effects of daytime sleepiness on productivity impairment.ConclusionsWe found that Calm (plus sleep coaching for a small subset of individuals) had beneficial effects on employee sleep, and these benefits on sleep were related to indirect effects on productivity impairment (ie, presenteeism, overall work productivity impairment, and non–work activity impairment). There were no overall main effects of Calm intervention on productivity impairment; however, insomnia appears to be a mechanism associated with benefits for employee productivity. This is one of the first studies to suggest that sleep benefits of a mindfulness mobile app may also indirectly relate to benefits for workplace productivity.Trial RegistrationClinicalTrials.gov NCT05120310; https://clinicaltrials.gov/ct2/show/NCT05120310

Telemedicine and Socioeconomics in Orthopaedic Trauma Patients: A Quasi-Experimental Study During the COVID-19 Pandemic.

Socioeconomic factors may introduce barriers to telemedicine care access. This study examines changes in clinic absenteeism for orthopaedic trauma patients after the introduction of a telemedicine postoperative follow-up option during the COVID-19 pandemic with attention to patient socioeconomic status (SES). Patients (n = 1,060) undergoing surgical treatment of pelvic and extremity trauma were retrospectively assigned to preintervention and postintervention cohorts using a quasi-experimental design. The intervention is the April 2020 introduction of a telemedicine follow-up option for postoperative trauma care. The primary outcome was the missed visit rate (MVR) for postoperative appointments. We used Poisson regression models to estimate the relative change in MVR adjusting for patient age and sex. SES-based subgroup analysis was based on the Area Deprivation Index (ADI) according to home address. The pre-telemedicine group included 635 patients; the post-telemedicine group included 425 patients. The median MVR in the pre-telemedicine group was 28% (95% confidence interval [CI], 10% to 45%) and 24% (95% CI, 6% to 43%) in the post-telemedicine group. Low SES was associated with a 40% relative increase in MVR (95% CI, 17% to 67%, P < 0.001) compared with patients with high SES. Relative MVR changes between pre-telemedicine and post-telemedicine groups did not reach statistical significance in any socioeconomic strata (low ADI, -6%; 95% CI, -25% to 17%; P = 0.56; medium ADI, -18%; 95% CI, -35% to 2%; P = 0.07; high ADI, -12%; 95% CI, -28% to 7%; P = 0.20). Low SES was associated with a higher MVR both before and after the introduction of a telemedicine option. However, no evidence in this cohort demonstrated a change in absenteeism based on SES after the introduction of the telemedicine option. Clinicians should be reassured that there is no evidence that telemedicine introduces additional socioeconomic bias in postoperative orthopaedic trauma care. III.

Work productivity in rheumatoid arthritis patients from two Latin American countries treated with tofacitinib or biological DMARDs

ABSTRACT Objective To evaluate work productivity of adult Latin American patients with rheumatoid arthritis (RA) treated with tofacitinib and biological disease-modifying anti-rheumatic drugs (bDMARDs) measured by the Work Productivity and Activity Impairment (WPAI) in RA questionnaire at 0- and 6-month follow-up. Methods This non-interventional study was performed in Colombia and Peru. Evaluated the effects of tofacitinib and bDMARDs in patients with RA after failure of conventional DMARDs. The WPAI-RA questionnaire was administered at baseline and at the 6-month (±1 month) follow-up. The results are expressed as least squares means (LSMs), and standard errors (SEs) were used as variability measures. Results One hundred patients treated with tofacitinib and 70 patients treated with bDMARDs were recruited. Twenty-eight percent of patients from the tofacitinib group and 40.0% from the bDMARDs group were working for pay at baseline. At month 6, the changes in absenteeism, presenteeism and work impairment due to health were -18.3% (SE 7.7), -34.8% (SE 5.9) and -11.0% (SE 16.5), respectively, in the tofacitinib group and -19.4% (SE 8.0), -34.8% (SE 6.2) and -15.9% (SE 15.0), for bDMARD group. Conclusion For patients who reported working, there were improvements in presenteeism, absenteeism and work impairment due to health in both groups. Trial registration NCT03073109

Improvement in Work Productivity After Group Voice Therapy in Professional Voice Users

A disordered voice may significantly impair the ability of workers to perform optimally on the job, especially those classified as professional voice users (PVU). Voice therapy is a common treatment option for voice disorders, but there are few studies demonstrating its effect on work productivity. The objective of this study was to evaluate the change in work productivity in PVU after group voice therapy. Prospective cohort study SETTING: Academic Voice Center METHODS: PVUs whose primary treatment for their voice disorder was voice therapy were recruited. Participants completed a 7-week group voice therapy course from January 2018 to December 2020. Participants completed the validated Work Productivity and Activity Impairment questionnaire (WPAI) which measured presenteeism (on the job work productivity impairment) and absenteeism (time missed from work), general self-efficacy scale (GSES), and Voice handicap index -10 (VHI-10) before and after group voice therapy. Changes in scores before and after therapy were compared using a Wilcoxon Signed-Rank test. Twenty-seven PVU were recruited; 25 had complete data (100% female, mean age 45.4 years, 68% teachers). Presenteeism (SD) decreased from 72.0% (23.3) to 36.8% (24.8), which represented a significant improvement of 35.2% (27.8) [95% CI 21.7-38.7; P < 0.001]. Activity impairment decreased from 48.4% (32.0) to 25.6% (23.8), which represented a significant improvement of 22.8% (26.5) [95% CI 20.7-37.0; P < 0.00]. There was no change in absenteeism (P = 0.27). Patients had high mean GSES of 34.4 (3.7) and abnormal mean VHI-10 of 18.2 (7.2). Changes in VHI-10 and GSES were not significant. PVU had an improvement in work productivity that was largely represented by decreased presenteeism after completing group voice therapy.

Presenteeism and absenteeism before and after single-level lumbar spine surgery

Background ContextHealth can impact work performance through absenteeism, time spent away from work, and presenteeism, inhibited at-work performance. Low back pain is common and costly, both in terms of direct medical expenditures and indirect reduced work performance. PurposeSurgery for lumbar spinal pathology is an important part of treatment for patients who do not respond to nonsurgical management. While the indirect costs of return to work and absenteeism among employed patients undergoing lumbar spine surgery have been studied, little work has been done to quantify presenteeism before and after lumbar spine surgery. Study Design/SettingProspective cohort study at a single high-volume urban musculoskeletal specialty hospital. PATIENT SAMPLEPatients undergoing single-level lumbar spinal fusion and/or decompression surgery. Outcome MeasuresPresenteeism and absenteeism were measured using the World Health Organization's Health and Work Performance Questionnaire before surgery, as well as 6 weeks, 6 months, and 12 months after surgery. MethodsAverage presenteeism and absenteeism were evaluated at pre-surgical baseline and each follow-up timepoint. Monthly average time lost to presenteeism and absenteeism were calculated before surgery and 12 months after surgery. Study data were collected and managed using REDCap electronic data capture tools with support from Clinical and Translational Science Center grant, UL1TR002384. One author discloses royalties, private investments, consulting fees, speaking/teaching arrangements, travel, board of directorship, and scientific advisory board membership totaling >$300,000. ResultsWe enrolled 134 employed surgical patients, among whom 115 (86%) responded at 6 weeks, 105 (78%) responded at 6 months, and 115 (86%) responded at 12 months. Preoperatively, mean age was 56.4 years (median 57.5), and 41.0% were women; 68 (50.7%) had only decompressions, while 66 (49.3%) had fusions. Among respondents at each time point, 98%, 92%, and 92% were still employed, among whom 76%, 96%, and 96% had resumed working, respectively (median 29 days). Average at-work performance among working patients (who responded at each pair of timepoints) moved from 75.4 to 78.7 between baseline and 6 weeks, 71.8 to 85.9 between baseline and 6 months, and 73.0 to 88.1 between baseline and 12 months. Gains were concentrated among the 52.0% of patients whose at-work performance was declining (and low) leading up to surgery. Average absenteeism was relatively unmoved between baseline and each follow-up. Before surgery, the monthly average time lost to presenteeism and absenteeism was 19.8% and 18.9%, respectively; 12 months after surgery, these numbers were 9.7% and 16.0%; changes represent a mitigated loss of 13.0 percentage points of average monthly value. ConclusionsPresenteeism and absenteeism contributed roughly evenly to preoperative average monthly lost time. Although average changes in absenteeism and 6-week at-work performance were small, average changes in at-work performance at 6 and 12 months were significant. Cost-benefit analyses of lumbar spine surgery should therefore consider improved presenteeism, which appears to offset some of the direct and indirect costs of surgical treatment.

Impact of a Structured Weight Management Program on Worker Productivity.

To determine the impact of an intensive behavioral weight management program on presenteeism and absenteeism in obese participants employed full-time. Participants were recruited from the University of Michigan Weight Management program (WMP), a multidisciplinary lifestyle program targeting 15% body weight loss. Absenteeism and presenteeism were assessed using the World Health Organization Health and Work Performance Questionnaire (HPQ) at baseline and 6 months. One hundred forty-two participants, predominantly college-educated white-collar employees, were included in the study. After 6 months in the program, there was no significant change in absenteeism or presenteeism compared with baseline. There was a trend towards reduced absenteeism. Participation in an intensive weight management program did not adversely impact worker productive time. Conversely, our findings should be reassuring to employer groups and to employees with obesity concerned about time spent away from work.

Spillovers from gatekeeping – Peer effects in absenteeism

We study peer effects in absenteeism among workplace colleagues. Gatekeeping is an essential task in many insurance systems. In this study we exploit exogenous shifts of general practitioners (GPs) occurring when physicians quit or retire. We find that these shifts induce changes in absenteeism for affected workers. By utilizing high-quality Norwegian matched employer-employee data with detailed individual information on certified sick leave during the period 2003–2012, we can study how the transfer of workers between GPs affects co-workers' absenteeism. We identify strong causal positive peer effects in absenteeism: a one day change in focal worker sickness absence transfers to a 0.41 day shift in peer absence.

The Impact of Worksite Wellness Programs by Size of Business: A 3-Year Longitudinal Study of Participation, Health Benefits, Absenteeism, and Presenteeism.

Worksite wellness programs (WWP) may positively impact employee health, medical expenditures, absenteeism, and presenteeism. However, there has been little research to assess the benefits of WWP in small businesses. The purpose of this study is to prospectively evaluate changes in health, absenteeism, and presenteeism for employees who participated in a WWP. We conducted an observational, 3-year cohort study of 5766 employees from 314 businesses of differing sizes. We followed two cohorts of employees, who completed at least two annual health risk assessments (HRA) between May 2010 and December 2014. Changes from baseline to the first and second follow-up periods were assessed for chronic and non-chronic health conditions, absenteeism, and presenteeism. Small business employees were more likely to participate in the WWP than were employees from large businesses. Changes in chronic and non-chronic health conditions varied by size of business, with small business employees showing improvements in stress, overall health, depression, smoking status, vegetable and fruit consumption, and physical activity, and in their perceptions of job health culture. In contrast, large business employees experienced improvements in stress, vegetable consumption, and alcohol use. No changes in absenteeism or presenteeism were observed. Small businesses achieve higher employee participation rates and more health improvements when compared to employees from large employers. Findings suggest that small businesses may gain the most from a WWP.

The cost of shift work: Absenteeism in a large German automobile plant

Using a balanced panel of some 400 organizational units in a large automobile plant, we analyse changes in absenteeism following a company innovation intended to improve worker health and well-being. During the period under consideration (January 2009–December 2011) the firm replaced its traditional shift schedule associated with high health risks for workers with an ergonomically more advantageous system. Our findings show that this innovation was accompanied by a statistically significant and economically relevant decrease in absenteeism. However, when workers started to express discontent with the new system, management after a few months implemented another shift system that was, from an ergonomical perspective, again associated with higher health risks than those associated with the second one. Absentee figures quickly returned to their initial levels. This suggests that short-term leisure preferences can override long-term health concerns in worker responses to the implementation of different shift schedules.

Disease activity decrease is associated with improvement in work productivity over 1 year in early axial spondyloarthritis (SPondyloArthritis Caught Early cohort).

To assess if a change in disease activity is associated with a change in work productivity loss (WPL) over 1 year in early axial SpA (axSpA) patients. Baseline and 1 year data of axSpA patients in the SPondyloArthritis Caught Early cohort were analysed. Linear regression models were built explaining the change in the Ankylosing Spondylitis Disease Activity Score (ASDAS) over time by the change in absenteeism, presenteeism, WPL and activity impairment over time. Effect modification and confounding were tested for age, gender, arm of Assessment of SpondyloArthritis international Society classification criteria, HLA-B27, duration of chronic back pain, profession and medication. At baseline, in 105 axSpA patients (48% female, mean age 30.8 years, mean symptom duration 13.6 months, 92% HLA-B27 positive, 24% radiographic sacroiliitis), the mean ASDAS was 2.4 (s.d. 1.0), absenteeism 9% (s.d. 23), presenteeism 33% (s.d. 28), WPL 36% (s.d. 30) and activity impairment 37% (s.d. 25). After 1 year, the mean ASDAS decreased to 2.0 (s.d. 0.8) and absenteeism, presenteeism, WPL and activity impairment improved to 6% (s.d. 22), 26% (s.d. 26), 27% (s.d. 29) and 27% (s.d. 26), respectively. Models showed that if ASDAS decreased 1 unit, absenteeism, presenteeism, WPL and activity impairment improved by 5, 17, 16 and 18%, respectively. The impact of disease activity on work productivity was higher in patients with shorter symptom duration and the impact on absenteeism was higher in patients starting pharmacological treatment. In early axSpA patients, work productivity and daily activities are seriously impacted at baseline and 1 year. However, decreasing disease activity is associated with marked improvements in work productivity and daily activities.

"When Positive is Better and Negative Stronger: A study of Job Satisfaction, OCB and Absenteeism"

Drawing mainly on momentum perspectives and prospect theory, the current study tests a team-level model of effects, attitudes and behavior changes. We use a longitudinal model in which team-level organizational citizenship behavior (OCB) mediates the relationship between team-level job satisfaction change and absenteeism change, and examine how such relationships are moderated by the direction of the momentum. This model was assessed using data at four time points, with a sample of more than 5,000 employees in 168 teams of a large Canadian energy organization. The results support the hypotheses that a positive change in team-level job satisfaction positively influences a positive OCB change and a negative change in absenteeism behavior in the same period of time. However, no significant support was found for the mediating effect of OCB change on the job satisfaction-absenteeism relationship over time. As expected, we found significant reciprocal effects between job satisfaction, OCB and absenteeism over t...

Long-Term Cost-Effectiveness of Adult Spinal Deformity Surgery

Introduction There is a lack of long-term outcomes in the existing cost-effectiveness literature. This study examines the long-term cost-effectiveness of surgical treatment of ASD with a Markov model populated by estimates from literature and observed data on hospital costs and outcomes. Using estimates from literature and observed data on costs and health-related quality-of-life (HRQOL) outcomes, we simulate costs and outcomes for surgical and nonsurgical treatment to estimate incremental cost-effectiveness ratios (ICERs) after 10- and 20-year follow-up. Material and Methods We develop a robust Markov model with parameter uncertainty, incorporating costs, and outcome distributions from published literature and observed patient data. Summary statistics on mortality rates, revision rates, and nonsurgical costs are taken from the literature, whereas statistics for surgical costs and QALYs are taken from a single-center, retrospective administrative data set and a multicenter prospective data set. Costs of surgery are measured as total hospital costs from administrative records. QALYs were calculated from the SF-6D. We projected costs and QALYs for the surgical and nonsurgical populations allowing varied readmission, cost, and QALY outcomes over 10- and 20-year follow-up. Costs for surgical and nonsurgical patients are intended to reflect the full spectrum of services incurred for surgical or nonsurgical care (e.g., physical therapy, pain management, etc.). Costs and QALYs were in 2010 dollars and discounted at 3.5%. Our results are based on 1,000 simulated patients, each proceeding through 6-month cycles over a 10- and 20-year follow-up periods. Confidence intervals are formed by repeating the simulations for 1,000 iterations. Results Discounted surgical costs averaged $170,523 over 10-year follow-up, with average discounted QALYs of 6.3. Meanwhile, nonsurgical costs averaged $40,046 over 10-year follow-up with average QALYs of 5.4. This resulted in an average ICER from surgical treatment of $144,000 (95% CI: $121,500–$177,500) per QALY gained. Over 20-year follow-up, surgical costs averaged $208,616 and QALYs averaged 9.8, whereas nonsurgical costs averaged $63,467 and QALYs averaged 8.6. Over 20-year follow-up, the ICER decreased (became more cost-effective) to $115,000 (95% CI: $88,850–$156,200) per QALY gained. Conclusion Our results illustrate the potential for surgical treatment for ASD to be cost-effective over extended follow-up compared with nonsurgical treatment. These findings argue in favor of longer follow-up in ASD studies for accurate cost-effectiveness comparison. Future research should also pursue measurement of indirect costs/benefits resulting from changes in absenteeism or productivity.

Health risk change as a predictor of productivity change.

To assess how health risk change influences concurrent and subsequent change in absenteeism and presenteeism. A retrospective, longitudinal study design analyzed repeated health assessment survey data using maximum likelihood structural equation modeling. A statistically significant relationship was detected between self-reported health risks at one point in time and lower productivity (absenteeism and presenteeism) at the same point in time as well as a longitudinal effect of increasing risks at one point in time associated with decreased productivity at subsequent measurement periods. Health is a predictor of productivity, and the benefits of improved health on improved productivity are cumulative over time.

Impact of changes in medical condition burden index and stress on absenteeism among employees of a US utility company

Purpose – The purpose of this paper is to investigate the impact of changes of medical condition burden index (MCBI) and stress on absenteeism and discuss implications for policy/program design. Design/methodology/approach – Sample: US utility employees that participated in Health Risk Appraisals (HRA) during 2009 and 2010 (n=3,711). Methods: the MCBI was created by summing number of medical conditions. Absenteeism was measured from administrative records. Change in MCBI and stress and impact on absenteeism was assessed according to incremental change, by low/high categorizations, and by using multivariate regression. Findings – Incrementally, greater changes in MCBI or stress generally resulted in corresponding absenteeism change. For both MCBI and stress, high categories were associated with greater absenteeism compared to those in low categories. Those remaining in the low MCBI category decreased absenteeism (−0.10 days/year; p=0.01). Changes from low to high MCBI resulted in increased absenteeism (+0.12 days/year; p=0.04. Changes in stress from low to high or from high to low categories resulted in concurrent changes in absenteeism (+0.21 days/year; p=0.04 and −0.31 days/year; p=0.01, respectively). Regression analyses indicated the interaction between stress and MCBI as a significant contributor to absenteeism change. Research limitations/implications – Conclusions: MCBI, stress and their interaction appear to be direct determinants of absenteeism. Companies should consider both physical and emotional health simultaneously in program interventions in order to reduce absenteeism. Originality/value – Unlike most studies illustrating cross-sectional relationships, this study shows how changes in stress and medical conditions relate to changes in absenteeism. The interaction between MCBI and stress in this context is also a novel addition.

A time‐lagged investigation of the impact of coworker behavior on the effects of demographic dissimilarity

SummaryAlthough it is clear that coworker absenteeism, tardiness, and turnover can influence an employee's actions, scholars have yet to consider the impact of relational demography on the adoption of these behavioral norms. Inspired by social identity, situational strength, and attraction‐selection‐attrition theories, we proposed that individuals who differ from their coworkers in age, sex, or racioethnicity would feel threatened by their outnumbered status and subsequently motivated to be absent, tardy, or more likely to turnover. However, we expected coworker withdrawal behavior to moderate whether or not dissimilar personnel act on these desires. Results from hierarchical multilevel modeling analyses of data from 470 U.S. call center workers nested in 51 work groups revealed that racioethnic dissimilarity was positively related to time‐lagged changes in absenteeism and tardiness as well as heightened turnover likelihood. These effects emerged only among employees whose coworkers engaged in greater withdrawal behavior. Importantly, racioethnically dissimilar employees working in more permissive climates (i.e., those with high levels of coworker absenteeism, tardiness, or turnover) exhibited the greatest increases in absenteeism and tardiness over three months and had the highest supervisor‐rated turnover likelihood. Implications for diversity management are discussed. Copyright © 2015 John Wiley &amp; Sons, Ltd.