Sickness Absence Costs Research Articles

Effects of Worksite Health Interventions Involving Reduced Work Hours and Physical Exercise on Sickness Absence Costs

To investigate the effects of physical exercise during work hours (PE) and reduced work hours (RWH) on direct and indirect costs associated with sickness absence (SA). Sickness absence and related costs at six workplaces, matched and randomized to three conditions (PE, RWH, and referents), were retrieved from company records and/or estimated using salary conversion methods or value-added equations on the basis of interview data. Although SA days decreased in all conditions (PE, 11.4%; RWH, 4.9%; referents, 15.9%), costs were reduced in the PE (22.2%) and RWH (4.9%) conditions but not among referents (10.2% increase). Worksite health interventions may generate savings in SA costs. Costs may not be linear to changes in SA days. Combing the friction method with indirect cost estimates on the basis of value-added productivity may help illuminate both direct and indirect SA costs.

NHS absenteeism is a “festering sore,” study says

Managers in the United Kingdom’s health services are failing to tackle staff absenteeism, which costs millions of pounds in lost productivity every year, a new study concludes. Healthcare has the highest levels of absenteeism levels of any sector, and a reduction of just 1% could save the NHS in England more than £34.2m (€39.2m; $55.7m) a year, say the authors, Vivienne Walker and David Bamford, from Manchester Business School ( Health Services Management Research 2011;24:142-50, doi:10.1258/hsmr.2011.011004). Sickness absence costs the UK economy £12bn each year, and the rate of absenteeism is much higher among public than private sector workers, they say. To reach their findings the researchers reviewed 140 previously published studies on absenteeism and carried out an in-depth investigation into …

Cost-effectiveness of interventions to return employees to work following long-term sickness absence due to musculoskeletal disorders

Sickness absence costs the UK economy around £20 billion per year. This study aims to assess the cost-effectiveness of interventions to return employees with musculoskeletal disorders to work, one of the major causes of long-term sickness absence, using a mathematical model. A Markov model was developed to assess the cost-effectiveness of three interventions: a workplace intervention; a physical activity and education intervention and a physical activity, education and workplace visit intervention. Extensive sensitivity analyses were undertaken to assess the impact of uncertainties upon the model results. All interventions assessed are estimated to have a cost per quality-adjusted life year gained below £3000 compared with usual care within the UK from a National Health Service (NHS) or societal perspective. Moreover, any intervention which returns at least an additional 3% of employees to work and costs less than an additional £3000 per employee, is likely to be considered economically attractive compared with usual care, relative to other interventions routinely funded by the NHS. This is the first economic evaluation in this area which extrapolates data beyond trial follow-up and synthesizes evidence from numerous sources. This sort of modelling approach should be considered for informing other public health policy decisions.

Sickness absence.

Staff sickness levels in the NHS vary dramatically across the country, but the Audit Commission says that by understanding and tackling the factors causing some of this variation the NHS can increase staff productivity, improve morale and save £290 million. It has produced a briefing that examines the local variation and cost of sickness absence to primary care trusts, NHS trusts and foundation trusts, and outlines where organisations can find more help and advice in cutting sickness absence rates.

Electronic fit notes: sickness certification in the new decade

Although estimates of the costs of sickness absence to the UK economy vary, as do the methods used to quantify these figures,1,2 it is clear that these costs exceed the total NHS budget. Annual costs of sickness absence and worklessness associated with ill health are estimated to exceed £100 billion per year.2 The costs to UK business of mental ill health alone are estimated at £26 billion each year.3 Despite these huge costs, this remains an under-researched area,4 and most of the research that has been done has been conducted in Scandinavia where the welfare and certification systems differ significantly from those in the UK and elsewhere.5 There are clear links between deprivation and worklessness and ill health. About 7% of the workforce are in receipt of long-term illness-related benefit. An alarmingly low proportion of them ever return to paid employment, locking themselves and their dependents into long-term deprivation and social exclusion,2 particularly in areas of low employment with up to a tenfold variation between UK regions.6 The arguments for enhanced family income for those on long-term sickness benefits are less robust since the welfare reforms and minimum wage have been introduced since 1997. Furthermore, recent modifications to disability legislation require employers to make reasonable workplace adjustments that can facilitate access to paid work for disabled adults and also accommodate the consequences of illness within the workplace. However, critics of the government's aim to reverse the drift towards increasing proportions of the workforce on …

Disease Management Programmes for Major Depression: Making the Financial Case

ABSTRACTDepression is a significant burden for the United Kingdom economy and despite conclusive evidence on the clinical efficacy of treatments and acknowledgements of the impact on quality of life, a high proportion still goes undiagnosed and untreated. The purpose of this paper is to present the economic case for a more structured approach to depression management, using techniques from the disciplines of health economics and actuarial science to demonstrate cost-effectiveness and return on investment. The results are presented first as an economic cost-effectiveness analysis, comparing the benefits of additional quality-adjusted life years (QALYs) with the costs, and secondly as a financial projection model of costs and savings, familiar to actuaries.The results of the model show that from a societal perspective, disease management programmes for depression are likely to both reduce costs and increase quality of life for patients in the overall adult population. This is also true from the perspective of an employer who has the cost burden of direct medical costs and sickness absence. For a healthcare payer who is not bearing the cost of sickness absence, such as a primary care trust (PCT) or private insurer, disease management programmes are likely to improve quality of life, but increase direct healthcare costs. However, the additional cost per QALY is well below the commonly used threshold in the U.K. of £30,000; therefore, most health economists would deem disease management programmes for severe and moderate depression to be a good use of public healthcare funds. The actuarial calculations, which show an internal rate of return for 45% to 50%, validate this conclusion.

Physical fitness, BMI and sickness absence in male military personnel

In modern society, decreased physical activity and/or changes in quality and quantity of nutritional intake contribute to obesity and lifestyle diseases that result in economic costs, both to society and to individuals. To measure physical fitness and body mass index (BMI) and to assess their association with sickness absence in male soldiers. Data regarding BMI and physical fitness (aerobic endurance and muscle fitness) were collected for male Finnish military personnel and combined with sickness absence data collected in the year 2004. The duration and costs of sickness absence were obtained from the personnel administration. A total of 7179 male military personnel (mean age 37, range 18-59; mean BMI 26.0, range 17-50) participated. There were large inter-individual variations in physical fitness and body mass. The group with the longest sickness absences (>7 days) exhibited lower muscle fitness in three of four tests and shorter running distance compared to the groups with shorter sickness absence (P < 0.001). In addition, high BMI, poor muscle fitness and poor aerobic endurance were associated with increased sickness absence. The present results showed that poor muscle fitness and endurance as well as high BMI are risk factors for productivity loss causing additional costs for the employer. Therefore, workers at a greater risk should be offered more multifaceted information about potential health risks, as well as motivational support to improve their lifestyle.

Stress poses dire threat to NHS

NHS Partners research highlights high number of acute staff under stress plus cost of sickness absence

Square Pegs and Round Holes? A Review of Economic Evaluation in Complementary and Alternative Medicine

Economic evaluation, linking the costs and consequences of an intervention to indicate the potential benefits of alternative interventions, is becoming established as one of the core tools for decision making in health care. As knowledge of the safety and effectiveness of complementary and alternative medicine (CAM) interventions increases, economic evaluation within CAM has a heightened significance. To explore whether the present framework for economic evaluation fits CAM and what modifications if any are needed for its application. Systematic review. A comprehensive search of four databases was undertaken (NHS Economic Evaluation Database, AMED, MEDLINE, CINAHL). Studies were included if they took the form of a comparative analysis of costs and consequences of a CAM treatment and were written in English. Each study was reviewed using a set of methodological questions to judge their quality as economic evaluations. A total of 19 studies were identified, of which 9 were cost-effectiveness studies, 7 cost-consequence studies, 2 cost-minimization studies, and 1 cost-benefit analysis. Seventeen (17) of the studies involved CAM treatments being used alongside mainstream or conventional treatments. The majority of the treatments aimed to alleviate pain, including chronic pain, back pain, neck pain, and migraine. Only a small minority of studies addressed wider outcomes of particular relevance to CAM disciplines. Nine (9) adopted a service provider perspective only, 7 included wider sickness absence costs and 3 patient costs. Only 1 study included costs to relatives. The quality of the cost and benefit dimensions of the studies was mixed. A CAM sensitive approach to economic evaluation is required. This needs to include a focus on outcomes that explore the range of effects of CAM treatment, an exploration of the client's perspective and not just that of the service provider and study designs that facilitate the individualized practitioner approach so central to CAM treatment.

The Business Value of Health Management

For organizational development that is future-oriented, enterprises increasingly need qualified, motivated and efficient workers who are able and willing to contribute actively to technical and organizational innovations. Furthermore, customers and consumers are increasingly interested in healthy products and services. Therefore, health has become a (potential) business value of strategic importance. In interaction with all relevant stakeholders, an approach was developed for companies that want to manage their health impact in a proactive and preventive manner. The approach was termed Integral Health Management (IHM). IHM forms a strategic approach for reducing the costs of sickness absence and working disability, while the productivity and resilience of the company and its employees are increased. This brings the company direct economic benefits. Finally, it is of prime interest for employees to remain physically and mentally healthy and employable. The IHM approach distinguishes seven lines of development: (1) health as a strategic company interest; (2) the realization of a healthy primary process; (3) a safe and sound physical (work) environment; (4) an inspiring social (work) environment; (5) vital people; (6) a sound relationship with the immediate organizational environment and local community, and (7) healthy products and/or services. The inter-relationships between the seven development lines are essential for combining an improvement of the business impact on health with a strategic interest of companies and organizations. The seven lines of IHM development can easily be linked to the European Foundation for Quality Management's European Excellence Model.

Primary care nurses' attitude to sickness absence: a study.

Nurses are under more pressure than ever before in a fast-changing NHS. Staff shortages and spiralling workload have led to escalating levels of stress in community care, while managers look to minimize the cost of sickness absence. However, the causes of sickness absence are complex and poorly understood. The authors report on a small-scale qualitative research study on the attitudes of primary care nurses to sickness absence. In-depth interviews were conducted with a small sample of volunteer nurses working in a west London primary care organization. Interviews were transcribed, coded and analysed into six main themes. It was found that psychological issues and values are very important but good management and the role of the team are also key factors in the decision to take sick leave. Workplace characteristics, personal issues, and local factors also play a very significant role.

A statistical human resources costing and accounting model for analysing the economic effects of an intervention at a workplace

The study had two primary aims. The first aim was to combine a human resources costing and accounting approach (HRCA) with a quantitative statistical approach in order to get an integrated model. The second aim was to apply this integrated model in a quasi-experimental study in order to investigate whether preventive intervention affected sickness absence costs at the company level. The intervention studied contained occupational organizational measures, competence development, physical and psychosocial working environmental measures and individual and rehabilitation measures on both an individual and a group basis. The study is a quasi-experimental design with a non-randomized control group. Both groups involved cleaning jobs at predominantly female workplaces. The study plan involved carrying out before and after studies on both groups. The study included only those who were at the same workplace during the whole of the study period. In the HRCA model used here, the cost of sickness absence is the net difference between the costs, in the form of the value of the loss of production and the administrative cost, and the benefits in the form of lower labour costs. According to the HRCA model, the intervention used counteracted a rise in sickness absence costs at the company level, giving an average net effect of 266.5 Euros per person (full-time working) during an 8-month period. Using an analogue statistical analysis on the whole of the material, the contribution of the intervention counteracted a rise in sickness absence costs at the company level giving an average net effect of 283.2 Euros. Using a statistical method it was possible to study the regression coefficients in sub-groups and calculate the p-values for these coefficients; in the younger group the intervention gave a calculated net contribution of 605.6 Euros with a p-value of 0.073, while the intervention net contribution in the older group had a very high p-value. Using the statistical model it was also possible to study contributions of other variables and interactions. This study established that the HRCA model and the integrated model produced approximately the same monetary outcomes. The integrated model, however, allowed a deeper understanding of the various possible relationships and quantified the results with confidence intervals.

Effects of changing the pattern of sickness absence referrals in a local authority.

The high costs of sickness absence in North Tyneside Metropolitan Borough Council prompted a review of the system of referral of cases of long-term sickness absence to their occupational health service for opinion about fitness to work. Earlier and more consistent referral of these employees produced reductions in average lengths of sickness absence. Time off before medical retirement was reduced from 72 weeks to 53 weeks, and time off before returning to work was reduced from 40 weeks to 25 weeks. Exact figures of the financial savings could not be calculated, but the estimated saving was 760,000 pounds in the first year. Although the occupational health service was not responsible for the whole of this saving, it played an important role in the exercise. It was concluded that earlier referral of employees with long-term sickness absence enabled decisions about returning to work to be made sooner, thus saving large amounts of money.