Workplace Absenteeism Research Articles

Impact of minimally invasive surgery on healthcare utilization, cost, and workplace absenteeism in patients with Incisional/Ventral Hernia (IVH).

Incisional hernia repair is one of the most common general surgery operations being performed today. With the advancement of laparoscopy since the 1990s, we have seen vast improvements in faster return to normal activity, shorter hospital stays and less post-operative narcotic use, to name a few. The key aims of this review were to measure the impact of minimally invasive surgery versus open surgery on health care utilization, cost, and work place absenteeism in the patients undergoing inpatient incisional/ventral hernia (IVH) repair. We analyzed data from the Truven Health Analytics MarketScan® Commercial Claims and Encounters Database. Total of 2557 patients were included in the analysis. Of the patient that underwent IVH surgery, 24.5% (n = 626) were done utilizing minimally invasive surgical (MIS) techniques and 75.5% (n = 1931) were done open. Ninety-day post-surgery outcomes were significantly lower in the MIS group compared to the open group for total payment ($19,288.97 vs. $21,708.12), inpatient length of stay (3.12 vs. 4.24 days), number of outpatient visit (5.48 vs. 7.35), and estimated days off (11.3 vs. 14.64), respectively. At 365 days post-surgery, the total payment ($27,497.96 vs. $30,157.29), inpatient length of stay (3.70 vs. 5.04 days), outpatient visits (19.75 vs. 23.42), and estimated days off (35.71 vs. 41.58) were significantly lower for MIS group versus the open group, respectively. When surgical repair of IVH is performed, there is a clear advantage in the MIS approach versus the open approach in regard to cost, length of stay, number of outpatient visits, and estimated days off.

Association Between Breast Cancer Disease Progression and Workplace Productivity in the United States.

Determine workplace productivity losses attributable to breast cancer progression. Longitudinal analysis linking 2005 to 2012 medical and pharmacy claims and workplace absence data in the US patients were commercially insured women aged 18 to 64 diagnosed with breast cancer. Productivity was measured as employment status and total quarterly workplace hours missed, and valued using average US wages. Six thousand four hundred and nine women were included. Breast cancer progression was associated with a lower probability of employment (hazard ratio [HR] = 0.65, P < 0.01) and increased workplace hours missed. The annual value of missed work was $24,166 for non-metastatic and $30,666 for metastatic patients. Thus, progression to metastatic disease is associated with an additional $6500 in lost work time (P < 0.05), or 14% of average US wages. Breast cancer progression leads to diminished likelihood of employment, increased workplace hours missed, and increased cost burden.

Responding to Workplace Absenteeism in Tanzania: The case study of Public and Private Schools in Ilala Municipality and Mkuranga District

Workplace absenteeism has widelybeen reported to be a serious problem which undermines smooth service delivery both in developed and developing nations.The problem is reported to be more serious in developing nation. This paper is therefore studyingthe mechanisms used to mitigate workplace absenteeism, their adequacy and the effective utilization of those mechanismsin public and private schools in Ilala Municipality and Mkuranga District in Tanzania. The study relied on in-depth interviews and documentary review to collect data which was analyzed using excel, content and thematic analysis. This study found numerous measureswhich have been put in placeto deal with teachers’ workplace absenteeism both in private and public schools.However, the study found that unlike in private schools, the measures are not seriously executed in public schools. The study recommends that the management of private schools should retain their strictness in dealing with teacher absenteeism. Also, the government should learn the private schools model of dealing with teachers’ absenteeism. Hence it should ensure effective utilization of available measures, improve teacher working environment, promotion and paying salary arrears on time. Again heads of schools should stop covering absenteeism behavior of their subordinates.Furthermore public secondary school management structure should be re- organized to introduce field of supervision at a division level.

The Influence of Mandatory Vs. Non-Mandatory Influenza Vaccination Policies on Workplace Absenteeism During Respiratory Virus Season

BackgroundWe analyzed data from health care personnel (HCP) participating in the multicenter, cluster randomized Respiratory Protection Effectiveness Clinical Trial (ResPECT) obtained over three viral respiratory (influenza) illness seasons (2012–2015) at three university health systems where influenza vaccination was mandated, and four Veterans Affairs (VA) health systems where it was encouraged but not mandated, to determine the incidence and duration of symptomatic influenza like illness (SILI) associated absenteeism.MethodsParticipants reported SILI daily, vaccination status, and days absent from work due to SILI weekly throughout a 12 week period during the peak viral respiratory illness season each year. Adjusted effects of vaccination and other modulating factors on absenteeism rates were estimated using multivariable regression models.ResultsOverall 97.1%, 96.3%, and 92.1% of participants reported being vaccinated during each of the three study years where the vaccine was mandated, while 67.9%, 63.3%, and 60.4% reported vaccination at sites where it was encouraged but not mandated. The percent of HCP claiming any sick days at mandatory sites was estimated to be 5.9% lower than at non-mandatory sites (95% CI, -12.5, -1.4; P = 0.02). Among HCP who reported at least one sick day, the mean number of symptomatic sick days at mandatory sites was 0.74 lower than at non-mandatory sites (95% CI, -1.37, -0.37, P < 0.01). After adjusting for possible confounding factors (e.g., season, vaccination statues, mandatory or non-mandatory vaccination site, age, children at home) the relative rate of sick days taken by vaccinated compared with unvaccinated subjects was reduced in the entire cohort of HCP and in the vaccinated compared with unvaccinated subset of HCP from non-mandatory sites (see Figure).ConclusionWe conclude that influenza vaccination rates are increased and SILI-related absenteeism is decreased at sites where influenza vaccination is mandated and that this should be one of the factors taken into consideration when healthcare facilities make decisions about influenza vaccination policies.FigureAdjusted Odds Ratio for Vaccination Status and Taking Any Sick Time, Adjusted Relative Rate of Sick Days Taken.Disclosures All authors: No reported disclosures.

Does Sick Pay Affect Workplace Absence?

Higher replacement rates often imply higher levels of absenteeism, yet even in generous welfare economies, private sick pay is provided in addition to the public sick pay. Why? Using comparative workplace data for the UK and Norway we show that the higher level of absenteeism in Norway compared to UK is related to the threshold in the Norwegian public sick pay legislation. This threshold's importance is confirmed in a Regression Kinked Design (RKD) analysis on the Norwegian micro-data. Private sick pay is provided as an employer-provided non-wage benefit and when training costs are high.

Leakage from medically-certified to self-certified workplace absence among norwegian employees

There are two different kinds of sickness absence in Norway: self-certified absence (SCA), and medically-certified absence (MCA). In this study of 6437 Norwegian employees, we applied logistic regr...

Job security provisions and work hours

This study explores the impact of job security provisions on workplace absence and overtime work. We hypothesize that job security provisions give individuals bargaining power to resolve work hour conflicts in their favour, but they may also create incentives for shirking. To examine the impact of job security provisions empirically, we implement a quasi-experimental research design based on a British job security provisions reform that extended dismissal protection among low-tenure workers. Using a difference-in-differences approach, we find that the reform increased absence rates due to workers taking more sickness absence and vacation days and reduced overtime work. Regarding the underlying mechanism, we obtain suggestive but limited evidence that the observed effects were driven both by reduced presenteeism and increased shirking.

Relationship between working and voice conditions self-reported by telemarketers of an emergency call center.

To investigate whether there is association between vocal symptoms, voice complaint, and working and voice conditions self-reported by telemarketers. Study participants were 72 telemarketing operators, both genders, who work in an emergency call center. They responded to a questionnaire on personal data, voice complaints, vocal symptoms, and working conditions. Data analysis was performed using the Chi-square, Mann-Whitney, and Fisher's Exact tests. Correlation was found between the telemarketers in the study group and voice disorder complaint for aspects of working condition, such as noisy working environment, and aspects of voice condition, such as change in the voice and workplace absence. Differences were observed between the mean of auditory vocal symptoms of participants for echo in the work room, change in voice, and workplace absence, as well as between the mean of their sensory vocal symptoms in relation to the variables stressful work rate, noisy working environment, noise from other rooms, echo in the work room, radio use, change in voice, and workplace absence. Correlation was found between the presence of vocal complaints, number of auditory and sensory vocal symptoms, and working conditions self-reported by the telemarketers surveyed.

Screening for depression in the occupational health setting.

The cost of workplace absenteeism and presenteeism due to depression in the USA is substantial. To assess the frequency of depression and its impact at the point of care in an occupational health (OH) practice. Patients presenting to an OH practice completed a standardized depression screening tool and were compared to an unscreened group in the same clinic. Respondents with a nine-item Patient Health Questionnaire (PHQ-9) score >15 and untreated for depression were referred for further evaluation per usual practice. A comparison group of unscreened patients were selected from the same clinic from 1 year prior and records were reviewed for evidence of prior depression, treatment and outcomes. After 1 year, frequency of depression, PHQ-9 scoring for screened patients, days absent from work, days on restricted duties and permanent restrictions were recorded for both groups. Two hundred and five patients were screened for depression. Screening was associated with increased frequency of a diagnosis of current depression (30 versus 4%; P < 0.05). Screening was associated with similar rates of absenteeism but lower number of days on restricted duties (97 versus 159 days; P < 0.001). After adjusting for age, sex, history of and treatment for depression, screening was associated with lower odds of being on work restrictions [odds ratio (OR) 0.55; 95% confidence interval (CI) 0.38-0.78] or permanent restrictions (OR 0.35; 95% CI 0.23-0.52). Depression was common in this OH practice. Screening for depression, with appropriate recognition and referral, may reduce time for employed patients on restricted duties and permanent restrictions.

PCN72 - Effects of Workplace Absenteeism on Financial Burden Faced by Women with Breast Cancer or Cervical Cancer

Workplace absenteeism may contribute to financial burden faced by women with breast cancer or cervical cancer. We examined relationships between paid leave and unpaid leave and having debt due to cancer in women with breast cancer or cervical cancer. Data from the 2011 Medicare Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement linked to MEPS Household Component data was used for all analyses. Inclusion criteria were a self-reported diagnosis of breast cancer or cervical cancer and having worked for pay since cancer diagnosis. Logistic regression was used to assess associations between binary predictor variables “Paid leave” and “Unpaid leave,” and the binary response variable, “Debt due to cancer.” Age, marital status and type of cancer were included as covariates. An a priori alpha of 0.05 was used for all analyses. The sample included 105 women with ages ranging from 25 years to 85 years with a mean ± standard deviation age of 57.31 ± 11.37 years. Among the sample, 46% (95% C.I., 34.11 - 53.42) of respondents had taken paid leave, and 70% (58.71 - 77.55) had taken unpaid leave for cancer. For every unit year increase in age, respondents were 0.91 times less likely to have debt due to cancer, odds ratio=0.91 (95% C.I., 0.86 - 0.96), p=0.001. Marital status, odds ratio=0.40 (95% C.I., 0.09 - 1.73), p=0.348, and paid leave, odds ratio=1.67 (95% C.I., 0.55 - 5.03), p=0.364, were not significantly related to having debt due to cancer. However, respondents with unpaid leave were 3 times more likely to have debt due to cancer compared to respondents without unpaid leave, odd ratio=3.03 (95% C.I.,1.11 - 9.09), p=0.043. Women with breast cancer or cervical cancer who had taken unpaid leave for cancer were significantly more likely to have debt due to cancer.

Commentary on: Micro-Shuttle Lifting of the Neck: A Percutaneous Loop Suspension Method Using a Novel Double-Ended Needle.

Nowadays, many women work outside the home and cannot accommodate an extended workplace absence to recover from invasive aesthetic surgery. Instead, a patient may elect to undergo noninvasive rejuvenation of the face and neck, a less costly option that can be performed in the surgeon's office and involves an abbreviated recovery time. The patient may return to work immediately postoperatively or within a few days. The market for rejuvenation of the face and neck has been flooded with techniques that involve threads and sutures, can be performed quickly, avoids aggressive surgical maneuvers, and precludes the overuse of fillers, which tighten tissues but …

Evaluating the economic impact of screening and treatment for depression in the workplace

Depression is the most common psychiatric illness and cause of disability, and associated with durable impacts on productivity and represents one of the major causes of workplace absenteeism and presenteeism. Few studies, however, examine the economic impact of treatment of depression in the workplace, particularly from the perspective of the employer. We estimated the relative cost-effectiveness of treatment for employees with depression in the workplace. We used a decision-analytic model to estimate the relative cost-effectiveness of (i) psychotherapy, (ii) pharmacotherapy and (iii) combination of psychotherapy and pharmacotherapy and whether they reduce sickness, absenteeism and presenteeism for people with depression. Costs and savings to the employer were also estimated, and policy recommendations made about how best to translate this evidence into practice. Both pharmacotherapy treatment and psychotherapy treatment were found to be cost-saving from the perspective of the employer. Psychotherapy was found to be the most cost-effective option with an incremental cost-effectiveness ratio of €22,225. This study provides evidence that screening and treatment for depression in the workplace is cost-effective and represents a worthwhile investment from the business perspective.

Physical Activity and Exercise Interventions in the Workplace Impacting Work Outcomes: A Stakeholder-Centered Best Evidence Synthesis of Systematic Reviews.

Background:The prevention of work disability is beneficial to employees and employers, and mitigates unnecessary societal costs associated with social welfare. Many service providers and employers have initiated workplace interventions designed to reduce unnecessary work disability.Objective:To conduct a best-evidence synthesis of systematic reviews on workplace interventions that address physical activities or exercise and their impact on workplace absence, work productivity or financial outcomes.Methods:Using a participatory research approach, academics and stakeholders identified inclusion and exclusion criteria, built an abstraction table, evaluated systematic review quality and relevance, and interpreted the combined findings. A minimum of two scientists participated in a methodological review of the literature followed by a consensus process.Results:Stakeholders and researchers participated as a collaborative team. 3363 unique records were identified, 115 full text articles and 46 systematic reviews were included, 18 assessed the impact of physical fitness or exercise interventions. 11 focused on general workers rather than workers who were absent from work at baseline; 16 of the reviews assessed work absence, 4 assessed productivity and 6 assessed financial impacts. Conclusion:The strongest evidence supports the use of short, simple exercise or fitness programs for both workers at work and those absent from work at baseline. For workers at work, simple exercise programs (1–2 modal components) appear to provide similar benefits to those using more complex multimodal interventions. For workers off-work with subacute low back pain, there is evidence that some complex exercise programs may be more effective than simple exercise interventions, especially if they involve workplace stakeholder engagement, communication and coordination with employers and other stakeholders. The development and utilization of standardized definitions, methods and measures and blinded evaluation would improve research quality and strengthen stakeholder-centered guidance.

Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis.

Conflicting recommendations exist related to which facial protection should be used by health care workers to prevent transmission of acute respiratory infections, including pandemic influenza. We performed a systematic review of both clinical and surrogate exposure data comparing N95 respirators and surgical masks for the prevention of transmissible acute respiratory infections. We searched various electronic databases and the grey literature for relevant studies published from January 1990 to December 2014. Randomized controlled trials (RCTs), cohort studies and case-control studies that included data on health care workers wearing N95 respirators and surgical masks to prevent acute respiratory infections were included in the meta-analysis. Surrogate exposure studies comparing N95 respirators and surgical masks using manikins or adult volunteers under simulated conditions were summarized separately. Outcomes from clinical studies were laboratory-confirmed respiratory infection, influenza-like illness and workplace absenteeism. Outcomes from surrogate exposure studies were filter penetration, face-seal leakage and total inward leakage. We identified 6 clinical studies (3 RCTs, 1 cohort study and 2 case-control studies) and 23 surrogate exposure studies. In the meta-analysis of the clinical studies, we found no significant difference between N95 respirators and surgical masks in associated risk of (a) laboratory-confirmed respiratory infection (RCTs: odds ratio [OR] 0.89, 95% confidence interval [CI] 0.64-1.24; cohort study: OR 0.43, 95% CI 0.03-6.41; case-control studies: OR 0.91, 95% CI 0.25-3.36); (b) influenza-like illness (RCTs: OR 0.51, 95% CI 0.19-1.41); or (c) reported workplace absenteeism (RCT: OR 0.92, 95% CI 0.57-1.50). In the surrogate exposure studies, N95 respirators were associated with less filter penetration, less face-seal leakage and less total inward leakage under laboratory experimental conditions, compared with surgical masks. Although N95 respirators appeared to have a protective advantage over surgical masks in laboratory settings, our meta-analysis showed that there were insufficient data to determine definitively whether N95 respirators are superior to surgical masks in protecting health care workers against transmissible acute respiratory infections in clinical settings.

Severe and enduring somatoform disorders: recognition and management

SummaryPatients with severe and enduring somatoform disorders (SESD) characteristically present with multiple, recurrent and frequently changing physical symptoms that have usually been present for several years before referral to a psychiatrist/psychologist. Many patients report long histories of contact with both primary and tertiary care services, have undergone repeated fruitless investigations and have high levels of disability. SESD are responsible for disproportionately high healthcare costs and are the third most common cause of workplace absence. Identification of patients with SESD by psychiatrists requires particular skills: collaboration with colleagues is vital and there are risks of iatrogenic harm. We describe the obstacles encountered in identifying these patients as well as methods of assessment and management. Treatment pathways best suited to managing this large and as yet untended group of patients are described.

Prevalence of depression among post graduate residents in a tertiary health care institute, Haryana

Background: Modern life is full of hassles, deadlines, frustrations, and demands. Chronic stressful life situations can increase the risk of developing depression. Depression is an illness that affects both the mind and the body and is a leading cause of disability, workplace absenteeism, decreased productivity, and high suicide rates. Globally, more than 350 million people of all ages suffer from depression. Depression may also sap the youthful energy of a medical student. It can make him dull and stifle his capacity to face the challenging situations that arise in medical profession. Objective: To determine the prevalence of depression among post-graduate residents in a tertiary health-care institute and its correlates. Materials and Methods: This cross-sectional study was undertaken among 120 post-graduate residents of Post Graduate Institute of Medical Sciences, Rohtak, Haryana during 1st June to 30th June 2013 using Beck Depression Inventory-II (BDI-II) questionnaire. The BDI is a 21-item self-administered instrument, rated on 4-point scale ranging from 0 to 3 and the total score being 63. Result: Of the 120 residents, 73 (61%) were males and 47 (39%) females. Nearly two-thirds of them (62%) were above 30 years of age and the rest (38%) below 30 years. Overall prevalence of depression was found to be 17% (Borderline and above in Beck depression inventory II). The residents above 30 years of age group and those who were married had significantly less prevalence of depression. The residents with history of smoking and alcohol consumption had higher odds [1.500 (0.572–3.931)] of having depression compared to those who did not. Conclusion: Our study found that nearly one-fifth residents were in depression. People with age

A cross-sectional study on depression from rural India

Background: Depression has been recorded since antiquity. It is an illness that affects both the mind and the body and is a leading cause of disability, workplace absenteeism, decreased productivity and high suicide rates. The present study was conducted in the rural field practice areas of Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh. The purpose of this study was to determine the prevalence and severity of depression in the study population and to assess the knowledge regarding causes of depression. Methods: 360 adult respondents were chosen using systematic random sampling to participate in the study. Face to face interviews were then conducted using a semi-structured proforma for collecting the data for socio-demographic and other factors. Depression in the subjects was assessed using the structured and pre-validated Patient Health Questionnaire-9 (PHQ-9). Results: The overall prevalence of depression was 11.9%. Majority of the subjects had moderate grades of depression. But knowledge regarding the causes of depression still comprised of certain supernatural causes. Conclusions: Rates of depression were quite comparable with the other studies. Depression was twice more in females. Apart from increasing mental health services and integrating this with general health services in our community there is also a dire need to focus on greater Information, Education and Communication activities regarding awareness of causes of depression and its prevention.

Attendance indicators for students in long-term nursing courses at a university hospital

Education is a social and universal phenomenon, being essential to the workplace and in a continuing regime. The pursuance of continuing education is common in the Nursing practice. Therefore, this study has the objective of describing the attendance indicators obtained by a Continuing Education Nursing Program at a University Hospital in 2012, in relation to the attendance of the students in long-term courses (greater than 20 hours). These courses are offered to the nursing staff under the pretext of understanding and supporting new health care strategies, which aim at improving the workforce of participants. The work herein is a descriptive, exploratory and retrospective study. During 2012 only three long-term courses were offered, all focused upon the specific needs of the hospital. In order to carry out the attendance evaluation a series of indicators were considered; daily presence percentage, general attendance percentage per student, attendance percentage of approved student, attendance percentage of reproved student, course abandonment percentage and approval percentage. The results showed differences in the attendance rates across all courses, both for those students who were approved as for those who were reproved, although the approval rate did not differ between the courses (40-50%). In the case of the course offered only to nurses, there were no abandonments registered. A noted phenomenon is that over the period the course runs, there also occurs a decrease in the daily attendance percentage on the part of students, thus demonstrating the need to implement new methodologies concerning this problem. Additionally, there occurred an attendance percentage and an approved and reproved percentage differential in results among the three nursing work categories, where nurses presented the highest rates of attendance and approbation. These results can be associated to the workplace position, voluntary participation and absence of liberation criteria for participation, all of which should be investigated in a future scenario. The results demonstrate the need for a methodology that maintains attendance levels across the whole duration of the long-term course, and deals with the presence of different professional categories and functions in the same course, under the intention of improving attendance and results of the long-term courses in continuing education programs.

Corporate Culture as Praxis: From Purpose to Profit

The concept of purpose is not antithetical to profit. A corporate culture that empowers meaningfulness produces dividends across the board: greater productivity, increased profits, decreased costs, and a system of activity that ties corporate managerial culture to tangible, enduring, and colossally positive human capital results. A well thought out and executed comprehensive system of values, beliefs and norms based on meaningfulness is the most powerful communication a company can choose about how it conducts business. Attempting to provide a company’s belief system using disconnected initiatives or a densely worded mission statement, most often estranged from an average worker’s daily activity, is likely to dilute work effort and commitment. Clear evidence is presented to prove that a strong corporate culture, with meaningfulness of work at its core, is a company’s most strategic asset that directly affects a company’s bottom line and creates an enduring and unique competitive advantage. Specific strategies to build, sustain, and measure a corporate culture within the framework of meaningfulness, where profit and purpose both thrive, are introduced. The positive outcomes of such a culture include significantly decreased workplace absenteeism, presenteeism, employee turnover, and workplace mental health costs, as well as increased profitability and customer satisfaction. Sustaining a meaningful culture can be efficiently managed through a “broaden- and-build” process, an outcome inherent in meaningful work which produces a network of positive emotions and personal resources that strengthens initiative, resilience, broadened attention and thinking that serve each employee well both within and outside the organization.

LBP - A Leading Cause of Workplace Absenteeism : Are We Doing Enough?

Low back pain (LBP) is a condition which affects most of the individuals at some point of time in their lives. The reportedprevalence of LBP in Indian population is highly variable, and ranges from 6.2% to 92%. The etiology of LBPcovers a vast number of factors including mechanical, psychogenic, degenerative, post traumatic and inflammatory causes. Meticulous history taking andphysical examination are of utmost importance while dealing with a case of LBR Various classes of medicines are available with promising results for control of LBR Non Steroidal Anti Inflammatory Drugs, selective COX2 inhibitors, muscle relaxants, opioid analgesics, tricyclic antidepressants, gabapentin, pregabalin etc. Non pharmacological intervention like spinal manipulation and acupuncture are of controversial effectiveness. Yoga and physiotherapy have evidence supporting their role in improving the pain. Strong need is there to improvise the conventional method of managing LBR Approximately 95% cases of LBP are of non speciJic mechanical wherein diagnostic imaging tests (including X-rays, CT and MRT) are not routinely indicated for acute non-specifi LBR Investigations should be limited for the small minority (<2-5%) where the cause of back pain is suspected to be either inflammatory (ie. systemic autoimmune diseases viz. ankylosing spondylitis or spondyloarthritis) or sinister. Active rehabilitation should be encouraged and the patients should not be prescribed bed rest as a treatntenf Management of LBPrequires an umbrella approach which, apart from pharmacological intervention, screening for psychosocial prognostic indicators in LBP may ultimately guide treatment protocols in physical therapy for more comprehensive patient care along with patient empowerment in terms of health education, participation in decision muking and responsibility of taking good self-care.