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PubMed2005

The friction-cost method : replacement for nothing and leisure for free?

The friction-cost method has been put forward as an alternative to the human-capital method as it allows more realistic estimates of productivity costs to be calculated for use in economic evaluations. The possibility of replacement of (long-term) absentees is at the heart of the friction-cost method. It recognises that society will restore initial production levels after some period of adaptation, the length of which may depend on the availability of labour and, hence, on unemployment. The friction-cost method has received two main criticisms in the literature: (i) it has no theoretical underpinning; and (ii) it treats leisure time as having no value. We demonstrate in a simple 'theoretical' time-allocation model how time use shifts in the friction-cost method and that leisure is not treated as having no value. Rather, it is considered to be valued in terms of QALYs--as is normally the case in economic evaluation. The time-allocation model also demonstrates that when using the friction-cost or human-capital method the changes in the amount of unpaid work and leisure time need to be valued separately. Unpaid production losses from the previously unemployed may be larger than the gain in unpaid production gain of the absentee, resulting in a societal loss of unpaid work or the sacrifice of leisure in order to make up for lost unpaid work. These changes should be incorporated into economic analyses.

Absenteeism↗
PubMed1998

Outcomes analysis of a summer asthma camp.

Forty children with moderate to severe asthma were enrolled in an asthma camp. Changes in peak flow meter (PFM) and metered-dose inhaler (MDI) technique, health care utilization, and school absenteeism were evaluated. The mean post-PFM score at the end of camp (8.9 +/- 0.3) was significantly higher (p < .0001) than the pre PFM score (6.0 +/- 3.4). The mean post-MDI score (6.5 +/- 1.5) was significantly higher (p < 0.0001) than the pre-MDI score (4.1 +/- 1.8). Emergency room visits decreased by 59%, hospitalizations decreased by 83%, and school absenteeism decreased from 266 to 188 days. Health care savings totaled $2014 per child enrolled.

Absenteeism↗
PubMed2005

Burnout as a predictor of medically certified sick-leave absences and their diagnosed causes.

Stress-related illnesses, such as mental, behavioral, and cardiovascular diseases, are common causes for sick-leave absences. It is generally assumed that burnout, the chronic stress syndrome, also leads to absenteeism and poor health, but this assumption has rarely been tested. The authors investigated the prospective effect of burnout on registered sick leaves and their causes in industrial employees. We collected the number of medically certified (> 3 days) absence episodes and their causes (according to the International Statistical Classification of Diseases-10 diagnostic categories) of 3,895 industrial employees from a company register during 1995 to 1998. Burnout was measured in 1996 with the Maslach Burnout Inventory-General Survey, which defines burnout as a 3-dimensional syndrome consisting of components of exhaustion, cynicism, and lack of professional efficacy. In Poisson regression models, the total burnout score increased the risk for future all-cause absences after adjustment for age, sex, occupation, and baseline absence. Burnout increased the risk of future absences because of mental and behavioral disorders, diseases of the circulatory system, diseases of the respiratory system, and diseases of the musculoskeletal system. Of the separate components of burnout, exhaustion was strongly related to future diseases of the circulatory system, whereas cynicism was strongly related to future diseases of the digestive system. Other differentiated effects were also found. The results of this study show that burnout is related to increased risk of future illness. This implies that burnout prevention can reduce future absenteeism and has a major economic impact on work life and health care.

Absenteeism↗
PubMedDate not supplied

The impact of a health campaign on hand hygiene and upper respiratory illness among college students living in residence halls.

Hand hygiene is a key element in preventing the transmission of cold and flu viruses. The authors conducted an experimental-control design study in 4 campus residence halls to determine whether a message campaign about hand hygiene and the availability of gel hand sanitizer could decrease cold and flu illness and school and work absenteeism. Their findings indicate that students who were exposed to the message campaign and provided with gel hand sanitizer increased their knowledge about the potential health benefits of hand washing and sanitizer use; they reported higher rates of hand washing and using sanitizer than did the control group. These students also experienced fewer cold and flu illnesses during the study than those in the control group and missed fewer class or work engagements because of colds or flu. Conducting a health promotion campaign in residence halls may therefore help prevent colds and flu and decrease absenteeism on university campuses.

Absenteeism↗
PubMed2002

Effectiveness of physical activity programs at worksites with respect to work-related outcomes.

This paper systematically reviews the literature on the effectiveness of physical activity programs at worksites with respect to work-related outcomes. A computerized literature search, a reference search, and a manual search of personal databases were performed using the following inclusion criteria: randomized controlled or controlled trial, working population. worksite intervention program to promote physical activity or physical fitness, and work-related outcomes. The study quality was evaluated using nine methodological criteria. Conclusions were based on a 5-level rating system of evidence. Eight studies (4 randomized controlled trials and 4 controlled trials) were identified, but their methodological quality was generally poor. The outcomes were absenteeism, job satisfaction, job stress, productivity, and employee turnover. The evidence of an effect was limited for absenteeism, inconclusive for job satisfaction, job stress and employee turnover, and nil for productivity. The scientific evidence on the effectiveness of physical activity programs at worksites is still limited. Because of the few high-quality randomized controlled trials, it is strongly suggested that this type of study be carried out. Future randomized controlled trials should pay special attention to the description of randomization, inclusion criteria, compliance, and analyses according to intention to treat.

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PubMed2005

Meta-analysis: exercise therapy for nonspecific low back pain.

BACKGROUND: Exercise therapy is widely used as an intervention in low back pain. OBJECTIVE: To evaluate the effectiveness of exercise therapy in adult nonspecific acute, subacute, and chronic low back pain versus no treatment and other conservative treatments. DATA SOURCES: MEDLINE, EMBASE, PsychInfo, CINAHL, and Cochrane Library databases to October 2004; citation searches and bibliographic reviews of previous systematic reviews. STUDY SELECTION: Randomized, controlled trials evaluating exercise therapy for adult nonspecific low back pain and measuring pain, function, return to work or absenteeism, and global improvement outcomes. DATA EXTRACTION: Two reviewers independently selected studies and extracted data on study characteristics, quality, and outcomes at short-, intermediate-, and long-term follow-up. DATA SYNTHESIS: 61 randomized, controlled trials (6390 participants) met inclusion criteria: acute (11 trials), subacute (6 trials), and chronic (43 trials) low back pain (1 trial was unclear). Evidence suggests that exercise therapy is effective in chronic back pain relative to comparisons at all follow-up periods. Pooled mean improvement (of 100 points) was 7.3 points (95% CI, 3.7 to 10.9 points) for pain and 2.5 points (CI, 1.0 to 3.9 points) for function at earliest follow-up. In studies investigating patients (people seeking care for back pain), mean improvement was 13.3 points (CI, 5.5 to 21.1 points) for pain and 6.9 points (CI, 2.2 to 11.7 points) for function, compared with studies where some participants had been recruited from a general population (for example, with advertisements). Some evidence suggests effectiveness of a graded-activity exercise program in subacute low back pain in occupational settings, although the evidence for other types of exercise therapy in other populations is inconsistent. In acute low back pain, exercise therapy and other programs were equally effective (pain, 0.03 point [CI, -1.3 to 1.4 points]). LIMITATIONS: Limitations of the literature, including low-quality studies with heterogeneous outcome measures inconsistent and poor reporting, and possibility of publication bias. CONCLUSIONS: Exercise therapy seems to be slightly effective at decreasing pain and improving function in adults with chronic low back pain, particularly in health care populations. In subacute low back pain populations, some evidence suggests that a graded-activity program improves absenteeism outcomes, although evidence for other types of exercise is unclear. In acute low back pain populations, exercise therapy is as effective as either no treatment or other conservative treatments.

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PubMedDate not supplied

Student attendance during college-based lectures: a pilot study.

AIM: To identify the factors that influence attendance and absenteeism among a group of second-year nursing students during the theory component of the Fitness for Practice (FFP) curriculum. METHOD: In 2004, a non-randomised questionnaire was used to elicit information about the factors surrounding absenteeism from 75 adult branch nursing students within the first FFP cohort. The questionnaire consisted of 48 questions and was designed to generate a mixture of quantitative and qualitative data. Absence was recorded for the first 91 weeks of the programme. RESULTS: The main reasons identified for absence included: illness, family commitments, dental and medical appointments, and impending assignment submissions. Other factors that might influence college attendance included a dislike of certain subjects, with ethics, law and social policy identified as the least popular subjects. Students also admitted to an increase in absence around the time when assignments are due for submission and occasionally pretended to be ill. CONCLUSION: Further studies should be undertaken with other pre-registration nursing student cohorts to compare the results with this research. There should be: an increase in self-directed learning; a 'family-friendly' approach to the curriculum by allocating self-directed study during school holidays; a reduction in the number of theory hours to coincide with students' external commitments and to assist them with the demands of studying; and time for private study before the submission of theoretical assignments.

Absenteeism↗
PubMed1992

The relationship between wellness participation and health care benefit utilization.

To examine the relationship between participation in a wellness program and the amount of absenteeism and medical claims, seven years of retrospective absenteeism and medical claims records were collected for 207 employees (pre- and postwellness intervention) and entered into a database. A proportional stratified random sample of workers by wellness participation was selected. While there was no significant change in the amount of sick leave taken over time, a log transformation revealed a significant increase in the dollar amount of medical claims over time, particularly for the middle-aged group of employees. This confirms that wellness intervention slowed the rate of increasing claims among middle-aged participants after just three years of wellness intervention.

Absenteeism↗
PubMed1992

Application form items as predictors of performance and longevity among respiratory therapists: a multiple regression analysis.

UNLABELLED: Errors in employee selection and consequent high turnover rates are expensive and can result in poor staff morale and possible harm to patients and personnel. METHOD: We investigated the predictive validity of commonly used application blank items as measures of future performance, absenteeism, tardiness, and tenure (the criterion variables) among 100 hospital-employed respiratory therapists and looked at the relationships among the criterion variables. RESULTS: Regression analysis showed the most significant predictive variables to be grade point average in respiratory therapy school, college education in addition to respiratory therapy training (particularly an associate degree in health sciences or a baccalaureate degree), and, surprisingly, the neatness of the application form itself. No important differences were found among the types of respiratory therapy program attended or the length of previous respiratory therapy experience. CONCLUSION: The data offer cautious evidence for the validity of some application items to predict some employee behaviors. The relatively low correlations among the criterion variables (absenteeism, tardiness, tenure, and performance) suggest that these items may be assessing substantially different aspects of employee behavior.

Absenteeism↗
PubMed1979

Determinants of job satisfaction in nursing care units.

Considerable attention has been placed on containing health care costs through structural approaches and budgetary means. Often overlooked in this process are costs associated to employee turnover and absenteeism. One of the important contributing factors to this withdrawal behavior is job satisfaction. Unfortunately few studies have explored the factors which influence the job satisfaction of health care workers. This study, using data collected from four hospitals, identifies fifteen factors that make major contributions to predicting the job satisfaction of nursing employees. This research suggests that the job satisfaction of nursing aides is influenced by procedures and practices that are organizational in their impact, by interactions with the work team and supervisor, and the daily activities of the nursing job. By understanding the interactive nature of these factors on job satisfaction, improvements in absenteeism and turnover can be realized with a reduction in personnel costs and improvements in quality of care.

Absenteeism↗
PubMed1999

Medical causes of female sickness absence during economic transition in Poland.

The current transformation of property relations and economic restructuring, along with many other factors, influence the health condition of workers. The present study was undertaken to investigate the trends in the rate and causes of female sickness absence during the period of economic transition in Poland, based on the absence analysis in one of the largest (before the process of restructuring) plants of the motor car industry. Vital for the current trends in the workers' absenteeism is the reduction in the rate of employment. The group investigated was composed of 3215 women and 5373 men employed during the years 1989-94. The main variable examined was the reason for the worker's discharge: (1) quitting the job because of health problems, (2) retirement, (3) termination of work contract due to economic problems of the plant, (4) change of affiliation agreed between the former and present employers. The structural transformations in the plant under study brought about the discharge of about 77% of workers during the period between 1989 and 1994, mostly owing to the termination of work contracts for economic reasons, and earlier retirement. The increase in the rate of sickness absence involved to a higher extent female workers; it amounted to 30% compared to 12% for male workers. Among the workers quitting employment, the rate of sickness absence was twice as high as that for the workers still under employment. The largest differences were noted for the female population; they concerned cardiovascular diseases, neoplasms and complications of pregnancy, delivery and the puerperium. The economic transformation processes make a considerable impact on the occurrence of sick absenteeism in workplaces. Workers leaving their jobs because of health problems, as well as those discharged for economic reasons belong to the highest risk group.

Absenteeism↗
PubMed2000

The cost of productivity losses associated with allergic rhinitis.

OBJECTIVE: To measure the cost of absenteeism and reduced productivity associated with allergic rhinitis. METHODS: The National Health Interview Survey (NHIS) was used to obtain information on days lost from work and lost productivity due to allergic rhinitis. Wage estimates for occupations obtained from the Bureau of Labor Statistics (BLS) were used to calculate the costs. RESULTS: Productivity losses associated with a diagnosis of allergic rhinitis in the 1995 NHIS were estimated to be $601 million. When additional survey information on the use of sedating over-the-counter (OTC) allergy medications, as well as workers' self-assessments of their reduction in at-work productivity due to allergic rhinitis, were considered, the estimated productivity loss increased dramatically. At-work productivity losses were estimated to range from $2.4 billion to $4.6 billion. CONCLUSION: Despite the inherent difficulty of measuring productivity losses, our lowest estimate is several times higher than previous estimates of the indirect medical costs associated with allergic rhinitis treatment. The most significant productivity losses resulted not from absenteeism but from reduced at-work productivity associated with the use of sedating OTC antihistamines.

Absenteeism↗
PubMed2001

Evaluation of the Japanese school health surveillance system for influenza.

In order to evaluate the Japanese nationwide school absenteeism surveillance system for pediatric influenza in comparison with the national sentinel surveillance for influenza, we used surveillance guidelines (Centers for Disease Control and Prevention, 1998) to determine the efficacy of the school health surveillance system (SHSS). Data regarding school absenteeism (age 4-15 years old) was compared with data regarding influenza-like illness (ILI) per sentinel sites during the second to the 11th weeks of 1998 and 1999. Despite the system's high simplicity and acceptability, telecommunication costs were estimated at US$ 490,000 (1998). Representativeness of schoolchildren was very accurate, but ILI for pre-school children (4-6 years) remained uncountable. Sensitivity, specificity, and positive predictive value of the SHSS compared to sentinel surveillance were calculated as 80%, 100%, and 100%, respectively (P=0.004). Although the SHSS was found to provide accurate surveillance data during periods of high influenza activity, non-influenza virus infections (e.g., adenovirus, rotavirus, and Norwalk virus, etc.) may become mixed in the SHSS data. Evaluation using this system should be continued employing a new case definition excluding gastrointestinal symptoms.

Absenteeism↗
PubMedDate not supplied

Absence from work among smokers and nonsmokers in Israeli industries--the Cordis Study.

While the negative economic effects of cigarette smoking are frequently examined in terms of the costs of health services and potential years of life lost, data on the indirect costs due to absence from work in Israel are scarce. During 1985-87, cigarette smoking habits and absence due to illness and accidents were examined in 5,826 employees (4,177 men and 1,649 women) in Israeli industry, screened in the framework of the Cordis Study. The absenteeism data related to the period 1986-87. Among men, smokers were absent an average of 2.6 days per employee more than nonsmokers (P < 0.001) over the 2-year period after adjusting for age and occupational category. Among women there was no significant difference in sickness absenteeism between smokers and nonsmokers. The excess days lost among male smokers was only partly explained by increased absence due to respiratory illness. Accident rates did not differ by smoking habits. There is a significant increase in absence due to illness among men employed in Israeli industry, which may be attributed to cigarette smoking. Since cigarette smoking continues to be a common practice, the overall costs to the economy may be considerable.

Absenteeism↗
PubMed1992

[Anti-influenza vaccination for active persons (25-64 years): a cost-benefit study].

This paper is a specific cost-benefit study concerning 25-64 years people flu vaccination. For this active population the vaccination rate is only 12% and the cost of absenteeism is potentially high. To make the balance between prevention costs and (direct and indirect) avoided costs by the vaccine, we use a basic case with mean value parameters as: efficacy rate of vaccine, impact of epidemics, size of vaccinated population, immunization length and compensation rate of the so-called production losses. These parameters are then supposed to vary in a sensitivity analysis. In any case net benefit of vaccination appears, which size varies mainly in relation to epidemics and vaccinated population extents. But improvements are to be achieved for giving more precise values to "real" efficacy rate of vaccination and effective economic impact of absenteeism on production.

Absenteeism↗
PubMed2005

Total costs of IBS: employer and managed care perspective.

Irritable bowel syndrome (IBS) is a common gastrointestinal motility disorder that typically affects persons of working age and is costly to employers. The financial burden attributable to the direct (use of healthcare resources) and indirect (missed days from work [absenteeism] and loss of productivity while at work [presenteeism]) costs of IBS is similar to that of other common long-term medical disorders, such as asthma, migraine, hypertension, and congestive heart failure. The symptoms of IBS are significantly bothersome and place a substantial burden on the personal and working lives of patients. As with other long-term medical conditions that have a significant impact on productivity, directed efforts by employers can address IBS in the workplace and thereby potentially decrease its impact. In this article, the symptoms of IBS and its impact on patients and on society as a whole are discussed; options are outlined by which employers can help reduce the total costs of IBS, including lost productivity (both absenteeism and presenteeism), in the workplace.

Absenteeism↗
PubMed1991

An urban primary school health program.

This paper summarizes the results of the first three years of an integrated on-site school health demonstration project based on the family practice model of delivering primary health care. An inner city public elementary school was chosen as the study location. Of the 712 study participants, 98% were black or Hispanic. Prior to implementation of the demonstration project, the Health Guarded Index for the study population was computed to be 58%. Among study participants, this index rose to 79% during the first year of the project and eventually reached 95% during the third year of the project. The absentee rates among study participants relative to nonparticipants decreased to 8.7% during the first year of the project and by 36.2% during the third year of the project. The substantial increase in the Health Guarded Index indicates that, among study participants, preventable defects, such as lack of immunizations, dental care, screening for common problems, and follow-up had been largely corrected. The substantial decline in absenteeism among study participants clearly shows the effectiveness of the demonstration project in promoting good health by decreasing morbidity and/or decreasing recovery time. Overall, the results of the three-year demonstration project reported here show that a carefully designed, well-coordinated school health program based on a family practice model can have a substantially favorable impact on the health of participating children.

Absenteeism↗
PubMed1989

School functioning and disease severity in boys with hemophilia.

There have been few recent studies investigating the scholastic progress of children with hemophilia. The advent of PL94-142, which ensures an appropriate educational program based on a child's specific learning disabilities, and home Factor VIII therapy, which increases the hemophiliac's school attendance and sense of freedom and control, might have had a positive impact on the academic performance of these patients. We investigated past and current educational functioning of 26 boys with hemophilia, using both parental and teacher reports. Twenty-two of these children were administered reading and math achievement tests. Results indicate that school absenteeism is a continuing problem for these children, with the average hemophiliac missing 18 school days in an academic year (median = 11 school days missed); one child had missed 77% of the year. Although these boys had normal intelligence and made average grades in school, six of the 22 tested performed more than two grade levels below expectations in reading and 10 performed greater than two grade levels below expectations in math. School underachievement did not necessarily correlate with disease severity (as indicated by serum factor level), school absenteeism, or grade point average. Although eight parents indicated that their children had past or current school problems, and teachers reported that greater than 50% of the group received special tutoring or classes for learning disabled students, six out of 22 (27%) performed below expectations in either math or reading and yet had no current individual educational remediation plan.(ABSTRACT TRUNCATED AT 250 WORDS)

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