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PubMed2004

Caregiving for ill dependents and its association with employee health risks and productivity.

This study examined the loss of productivity and health risk status associated with employees who provide care for an ill dependent. A total of 16,651 employees (23% response rate) of a major financial services company completed a confidential Health Risk Appraisal (HRA) that included an eight-item version of the Work Limitations Questionnaire and a self-report of time missed from work during the previous 2 weeks to care for an ill dependent. A total of 10.6% of the respondents reported an average of 7.7 hours absent from work during the previous 2-week period to provide care for an ill dependent. Caregiving also was associated with a significant increase in the number of health risks for the employee. As the demand for caregiving time increased, caregivers reported a significant increase in work limitations. Caregiving for an ill dependent is associated with increased absenteeism and significant work limitations while on the job. Programs and work organization that helps employees balance their caregiving responsibilities for ill dependents may have a positive effect on health and productivity.

Absenteeism↗
PubMed2005

Employees with overactive bladder: work loss burden.

OBJECTIVE: This study assessed the indirect work loss costs to employers as the result of employees with overactive bladder (OAB). METHODS: Study samples were drawn from an administrative database of 1.2 million beneficiaries, including medical and disability claims (1999-2002). OAB employees were compared with matched employees without OAB. RESULTS: OAB was associated with higher annual occurrences of work loss (P < 0.01). Employees with OAB had 2.2 excess work loss days as the result of medically related absenteeism and 3.4 excess days as the result of disability compared with employees without OAB (P < 0.01 for both comparisons). Employees with OAB had increased risk of disability (P < 0.01), and female employees with OAB had a higher risk of disability than male employees (P < 0.01). CONCLUSIONS: This study found that OAB was associated with work loss costs to employers resulting from increased number of employee sick days and increased risk of employee disability.

Absenteeism↗
PubMed2005

The burden of pain on employee health and productivity at a major provider of business services.

OBJECTIVE: The objective of this study was to examine the burden of pain on employee health and productivity at a Fortune 100 company headquartered in the northeastern United States to prioritize target areas for reducing this burden. METHODS: An electronic survey was conducted in late 2004, which produced a reasonably representative national sample of 1039 active employee respondents. RESULTS: A total of 28.6% of respondents met the study definition for pain. Pain was linked to: 1) drops of more than 45% and 23%, respectively, in Overall Physical and Mental Health; 2) a fivefold increase in health-induced limitations in work performance; and 3) nearly three and two thirds workdays lost to presenteeism and absenteeism over a 4-week period. Afflicted workers displayed considerable room for improvement in their capacity for pain control and management. CONCLUSIONS: The prevalence of pain and its impact on those with the condition combine to make it an area of much opportunity for improving workforce health and productivity. Musculoskeletal diseases offer a promising initial target for corporate intervention.

Absenteeism↗
PubMed2005

Economic costs of benign prostatic hyperplasia in the private sector.

PURPOSE: Several studies document the impact of benign prostatic hyperplasia (BPH) in working, aged men. Direct medical costs related to BPH treatment are largely borne by employees through higher premiums. However, indirect costs related to lost work are primarily borne by the employer. In this study we used claims data and absentee records from large employers to estimate the costs associated with BPH in working age males. MATERIALS AND METHODS: We used 2 data sources to examine direct and indirect costs associated with BPH in a privately insured, nonelderly population. Multivariate regression models were used to predict spending for persons with and without a medical claim for BPH, controlling for relevant covariates. Data on work loss were linked to medical claims to estimate work loss related to treatment for BPH. RESULTS: Mean annual expenditures were 4,193 dollars for men without a medical claim for BPH. In contrast, annual spending was 5,729 dollars for men with a claim for BPH. Thus, the incremental cost associated with a diagnosis of BPH was 1,536 dollars yearly. Overall the average employee with the condition missed 7.3 hours of work yearly related to BPH with approximately 10% reporting some work loss related to a health care encounter for BPH. CONCLUSIONS: Treatment of men with BPH places a significant burden on employees and their employers through direct medical costs as well as through lost work time. Direct and indirect costs to the private sector related to BPH treatment are estimated to be 3.9 billion dollars.

Absenteeism↗
PubMed2006

The indirect costs of arthritis resulting from unemployment, reduced performance, and occupational changes while at work.

OBJECTIVE: The objective of this study was to assess the cost attributable to lost productivity from arthritis and the association between the degree of loss and demographic, disease-related, occupational, and psychosocial variables for people. METHODS: In a prospective study, 383 employed individuals with arthritis were recruited from southwestern Ontario, Canada. Respondents completed structured questionnaires assessing demographic, disease-related, workplace, and psychosocial variables as well as employment-related transitions at 2 time points 18 months apart. Indirect costs resulting from arthritis-related absences, reduced performance, decreased work hours, job change, and work disability were estimated. A proportional odds model was used to assess the impact of the various variables on lost productivity. RESULTS: The average cost attributable to arthritis was CAN Dollars 11,553(Dollars CAN = 0.75 Dollars US) per person per year. The largest component of the loss was the result of reduced performance at work, which accounted for 41% (Dollars 4724) of the total loss. This was followed by wage loss resulting from stopping working or changing jobs, which comprised 37% (Dollars 4309) of the total. Another 12% (Dollars 1398) and 10% (Dollars 1121) of the loss were the result of the decrease in hours of work and absenteeism, respectively. Four variables were associated with the productivity loss: greater symptom severity (odds ratio [OR] = 1.11), low or medium control over the work schedule (OR = 0.55 and 0.60, respectively), greater workspace limitation (OR = 1.10), and higher depression (OR = 1.04). CONCLUSIONS: Indirect arthritis-related costs are substantial. Our results show that not only the disease itself, but also psychosocial and work-related factors affect the magnitude of the costs.

Absenteeism↗
PubMed1990

Respiratory virus infections and performance.

Minor illnesses, such as colds and influenza, are frequent, widespread and a major cause of absenteeism from work and education. Yet the clinical symptoms of such illnesses may not be so great as to stop people from working or from carrying out everyday activities. It is therefore important to determine whether these viral infections alter central nervous system function and change performance efficiency. Data on this topic are almost non-existent, which in part reflects the difficulties inherent in carrying out such studies. In real life it is almost impossible to predict when such illnesses will occur, and difficult to establish which virus produced the illness. This problem was overcome by studying experimentally induced infections and illnesses at the Medical Research Centre (MRC) Common Cold Unit in Salisbury. Results from this research programme show that: (i) colds and influenza have selective effects on performance; (ii) even sub-clinical infections can produce performance impairments; (iii) performance may be impaired during the incubation period of the illness; (iv) performance impairments may still be observed after the clinical symptoms have gone. These results have strong implications for occupational safety and efficiency and it is now essential to assess the impact of naturally occurring colds and influenza on real-life activities.

Absenteeism↗
PubMed1996

Lies, damned lies and absence statistics.

Examines the extent of absenteeism and the associated costs. Considers recent guidance on indicators of absence rates and notes the difficulties in reaching a common interpretation of the advice given. Outlines the challenge in devising feedback to local managers which enables local interpretation. Recommends training for first-line managers.

Absenteeism↗
PubMed1993

Omeprazole versus famotidine in the healing and relapse of duodenal ulcer.

Sixty patients with symptomatic duodenal ulcer were randomized to receive either omeprazole (20 mg each morning) or famotidine (40 mg at night time) for 2-4 weeks in a double-blind parallel group clinical trial. Healing rates were higher with omeprazole in comparison with famotidine after 2 weeks (77% vs. 40%, P < 0.001) and 4 weeks (93% vs. 80%, P = 0.2) of treatment. Assessment of daily diary cards completed by all patients revealed that omeprazole rapidly relieved ulcer-related day pain and nocturnal pain in comparison to famotidine. Treatment with omeprazole for 2 weeks was also associated with lower cumulative antacid intake (P < 0.05) and reduced absenteeism from work. Helicobacter pylori infection was present in all patients and remained unaffected by treatment with either of the drugs. None of the drugs produced any significant adverse effects. During 6 months follow-up of all the patients after ulcer healing (without maintenance therapy), ulcer relapse was seen in 40% of omeprazole- and 37% of famotidine-treated patients (P > 0.1). The duration of ulcer-free period following initial healing of ulcer was also similar in both the groups (median time: 22 weeks for omeprazole, 21 weeks for famotidine). We conclude that omeprazole is superior to famotidine in rapidly healing duodenal ulcers and achieving more rapid pain relief, but does not influence subsequent ulcer relapse.

Absenteeism↗
PubMed2005

Effect of tegaserod on work and daily activity in irritable bowel syndrome with constipation.

BACKGROUND: Tegaserod is a promotility agent with proven efficacy and safety in patients with irritable bowel syndrome with constipation. AIM: To assess tegaserod's effect on work productivity and daily activity. METHODS: Women, 18-65 years old and meeting Rome II criteria for irritable bowel syndrome with constipation, were randomized to a double-blind, placebo-controlled, multicentre study of tegaserod 6 mg b.d. or placebo. Productivity loss and daily activity impairment because of irritable bowel syndrome were measured with the Work Productivity and Activity Impairment questionnaire for irritable bowel syndrome, modified to exclude diarrhoea as a symptom. Assessments were made at baseline, weeks 2 and 4. RESULTS: A total of 2660 women were randomized and, of these, 1675 [tegaserod (n = 1363), placebo (n = 312)] were employed and completed Work Productivity and Activity Impairment for irritable bowel syndrome questionnaires. Compared with placebo, tegaserod significantly reduced work and daily activity impairment at weeks 2 and 4. Tegaserod reduced absenteeism by 2.6% (P = 0.004), presenteeism by 5.4% (P < 0.0001), overall work productivity loss by 6.3% (P < 0.0001), and activity impairment by 5.8% (P < 0.0001) at week 4 (vs. baseline). Assuming a 40-h workweek, tegaserod reduced work productivity loss by 2.5 h/week. CONCLUSIONS: Tegaserod significantly reduced work productivity loss and daily activity impairment at 2 weeks, and this benefit was maintained at 4 weeks.

Absenteeism↗
PubMed1987

Staff sickness and its relationships to violent incidents on a regional secure psychiatric unit.

This study aimed to examine the relationship between absenteeism in nurses and disturbed and/or violent incidents in patients. It was conducted in the Interim Secure Psychiatric Unit at the Bethlem Royal Hospital, London (which later transferred to the Denis Hill Unit) during 1985. Data was gathered from sickness figures recorded on the ward and in the nursing administration office. Violence records were collected from incident reports made by all grades of nursing staff. The hypothesis to be tested was that as violence increased then staff sickness would decrease. Results indicate that such a correlation is not present. However, staff sickness was significantly concentrated around days off. Some considerations for future research are given.

Absenteeism↗
PubMed2006

The health promotion model as assessed by ageing workers.

AIMS: This study describes qualitatively ageing workers and their health promotion. It also describes quantitatively the importance of individual, workplace and occupational health promoting factors, the impact of health promotion and the contributions of the other co-partners promoting the health of ageing workers. These form the foundation for a model of health promotion. BACKGROUND: Very little is known about the health promotion factors exclusively focused at ageing workers. METHODS: A pretested questionnaire with structured and some open-ended questions were devised to form the basis of qualitative data and sent to 150 ageing workers, of whom 93 (62%) returned it. Qualitative data were analysed by content analysis. Statistical analyses were performed using frequencies and means. RESULTS: Over 90% of respondents stated that health habits, individual arrangements at the workplace, a good workplace spirit, health checks, counselling and access to nursing care were important factors for health promotion. Better health (99%), work satisfaction (95%) and motivation of employees (96%) were the factors impacting on health promotion. Ageing workers stated that health and safety organization (94%) and rehabilitation institutes (93%) were the most important co-partners. CONCLUSIONS: This study confirms extremely high importance of different health promotion factors, their impact and some co-partners. Health problems, early retirement and work absenteeism are rather common in ageing workers. If we are to avoid these problems, it is important to support their work ability effectively and systematically to allow these workers to stay employed until the normal retirement age. Relevance to clinical practice. It is necessary, that management appreciate the benefits of ageing workers; they have to take a positive attitude toward these workers and participate more effectively in their health promotion. Occupational health professionals play a key role in training workers and management to undertake the required measures.

Absenteeism↗
PubMed1991

Evaluation of a structured treatment and teaching programme on asthma.

The objective of this study was to evaluate a structured treatment and teaching programme for adult patients with moderate to severe asthma. The design consisted of a prospective, before-after trial: the same consecutive patients were studied before and after intervention with observation periods 1 year before and 1 year after intervention. The investigation took place within a tertiary care centre (university hospital). A total of 142 consecutive patients were referred for in-patient treatment of their asthma, of whom 132 (93%) patients participated in the follow-up examination. The intervention consisted of a structured 5-d in-patient treatment and teaching programme presented by a specialized nurse educator. The aim of the programme was for the patient to assume greater responsibility for disease management, including self-monitoring of peak expiratory flow and qualified self-adaptation of drug therapy. The main outcome measures were the frequency of severe asthma attacks, hospitalization, and absenteeism from work (data provided by health insurance companies), patients' compliance and management skills. During the year before and the year after the intervention 71% and 36%, respectively of patients had one or more severe asthma attacks (mean difference 35%, 95% CI: 25-45%, P less than 0.0001). The percentage of patients who were hospitalized because of asthma decreased from 39% to 22% (mean difference 17%, 95% CI: 7-27%, P less than 0.002). The percentage of employed patients (n = 67) who were absent from work because of asthma decreased from 60% to 43% (mean difference 17%, 95% CI: 4-30%, P less than 0.04). The patients' adherence to maintenance drug therapy and their management skills improved significantly. It was concluded that the participation of patients with moderate to severe asthma in a structured treatment and teaching programme resulted in a substantial reduction in asthma morbidity in the year following the intervention.

Absenteeism↗
PubMed2005

Stress and verbal abuse in nursing: do burned out nurses eat their young?

AIM: The purpose of this study was to explore the types and frequency of verbal abuse of nurses by other nurses. Further, this study explored the components, characteristics, consequences and effects of abuse in an effort to better understand the dynamics of verbal abuse of nurses in the workplace. Nurses who experience occupational burnout are more likely to abuse other nurses. BACKGROUND: It is believed that nurses have been historically subjected to verbal abuse by colleagues, something previously considered to be done primarily by doctors. The effects and consequences of verbal abuse can be devastating and long-lasting. Research that has focused on its consequences has found that it is both physiologically and psychologically damaging. METHOD: Participants completed an adapted survey, incorporating the Verbal Abuse Scale and the Verbal Abuse Survey and demographic questions developed by the researchers. Specifically, types of verbal aggression, the frequency and stressfulness of each type, emotional reaction to verbal aggression, cognitive appraisal of verbally aggressive encounters, and similarity and effectiveness of coping behaviours were explored. The long-term negative effects of verbal aggression, including absenteeism and errors in patient treatment, were also evaluated to determine if verbal aggression is a contributing factor. RESULTS: Respondents reported that the most frequent source of abuse was nurses (27%), followed by patients' families (25%), doctors (22%), patients (17%), residents (4%), other (3%) and interns (2%). Of those who selected a nurse as the most frequent source, staff nurses were reported to be the most frequent nursing source (80%) followed by nurse managers (20%). CONCLUSIONS: Verbal abuse in nursing is quite costly to the individual nurses, the hospitals and the patients. Nurses who regularly experience verbal abuse may be more stressed, may feel less satisfied with their jobs, may miss more work and may provide a substandard quality of care to patients.

Absenteeism↗
PubMed1993

DSM-III-R disorders, social factors and management of school attendance problems in the normal population.

Eighty 13-15-year-old children who failed to attend one of four schools for more than 40% of a term, without good reason, were studied. A systematic schedule (C.A.P.A.) was used in interviewing parents and children. Twenty-five had DSM-III-R Disruptive Behaviour Disorders and 15 had Anxiety/Mood Disorders. Truancy was associated with the former and school refusal with the latter but both often occurred without any Disorder. Fourteen children had neither school refusal nor truancy. Compared to controls, poor attenders came from materially disadvantaged homes. School refusal with anxiety disorders rarely received psychiatric treatment. Non-disturbed absentees were not usually dealt with appropriately.

Absenteeism↗
PubMed1983

Identification and intervention of heavy drinking in middle-aged men: results and follow-up of 24-60 months of long-term study with randomized controls.

In a continuing screening and intervention programme in Malmó, elevated serum-gamma-glutamyltransferase (GGT) values were used for selection of heavy drinkers. The study population consisted of 585 individuals born 1926-1933 with two consecutive GGT values in the upper decile of the GGT distribution, randomly allocated either to an intervention group of to a control group. The subjects in the intervention group were further investigated and 75% of them were judged to have elevated GGT values caused by alcohol consumption. These individuals were repeatedly encouraged to lower their overall alcohol consumption and GGT measurements were used as biofeedback method in the treatment program. The controls were informed by letter to be restrictive with their alcohol consumption and that they should receive new invitations for measurements of their liver enzymes after 2, 4, and 6 years. The intervention and control groups were well matched and followed over a 2-6-year period. Two and 4 years after the screening investigation, the GGT values in both groups were significantly decreased. There were differences, however, between the two groups with regard to sick absenteeism, hospitalization, and mortality. A significant reduction was found in sick absence during 4 years by 80%, in hospital days during 5 years by 60%, and in mortality during 6 years by 50% in the intervention group compared with the control group. Thus, the intervention program was effective in preventing medico-social consequences of heavy drinking.

Absenteeism↗
PubMed1984

Twelve-month surveillance of infections in institutionalized elderly men.

Surveillance of infectious episodes in institutionalized elderly men permanently resident on two wards of a veterans' hospital was undertaken for a 12-month period. One-hundred eleven episodes were identified in 50 residents (74 per cent). The most frequent infections included lower respiratory tract infections (incidence 59/100 patient-years), febrile episodes with no source (43.4), skin and soft tissue infections (36.5), and gastroenteritis (33). Only pneumonia was associated with significant mortality. A specific etiologic agent was seldom identified other than for skin and soft tissue infections. Antimicrobial therapy was prescribed for 87 per cent of all infections. Ward staff absenteeism was associated with peak occurrences of infections in residents. Resident characteristics that correlated with infection were incontinence of bladder and of bowel. Mental status or degree of mobility did not correlate. While infections occur frequently in this population, mortality is common only with pneumonia. Infections occur more frequently in residents who have greater functional impairment.

Absenteeism↗
PubMed2001

Dedicated asthma center improves the quality of care and resource utilization for pediatric asthma: a multicenter study.

OBJECTIVES: To determine the relative effectiveness of pediatric asthma care among patients treated by a dedicated asthma center (AC) vs children who use the emergency department (ED) as a site of primary asthma care. METHODS: A retrospective case-control design was used. A random sample of AC cases was selected from a designated comprehensive AC over a 12-month period. Concurrent ED control patients were identified from all cases of pediatric asthma from five urban hospitals based on two or more ED visits. Cases and controls were matched (1:2) based on age and National Heart, Lung, and Blood Institute (NHLBI) asthma severity of illness classification. A telephone survey was administered to the caregivers of all enrolled patients in the study sample. RESULTS: Four elements of pediatric asthma care were examined: quality, access, hospital utilization, and functional impact of disease. Demographic data were similar between the ED cases and the AC controls. In terms of quality of care, the AC patients were more likely to use maintenance antiinflammatory medications, 60.2% vs 22.5% (OR = 5.3; 95% CI = 2.9 to 9.7) and more likely to be taking medications at school, 71.4% vs 48.1% (OR = 2.7; 95% CI = 1.5 to 4.7). In terms of access to care, the AC families were more likely to have a physician to call to assist with outpatient management, 98.2% vs 65.0% (OR = 25.3; 95% CI = 9.0 to 76.9). Frequent ED utilization (> or = 1 visit/month) was less likely in the AC patients, 9.2% vs 22.0% (OR = 0.35; 95% CI = 0.16 to 0.79) and school absenteeism was lower as well (9.5 +/- 6.7 days vs 16.6 +/- 10.3, p < 0.001). Additionally, the caregivers of the AC patients missed fewer workdays (4.7 +/- 2.8 vs 7.4 +/- 4.1; p = 0.03). CONCLUSIONS: Significant disparities in quality, access, resource utilization, and functional impact exist between AC and ED patients. Emergency physicians have a unique opportunity to improve the public health by directing ED patients toward pediatric AC treatment.

Absenteeism↗
PubMed1997

The free-running asthma screening test: an approach to screening for exercise-induced asthma in rural Alabama.

This study documented the prevalence of exercise-induced asthma (bronchospasm) in rural elementary schools and described the use of a free-running asthma screening test (exercise-challenge) and peak expiratory flow rate measurements for screening in a school setting. Of 437 children screened, 25 (5.72%) had a > or = 15% decrease in post-exercise peak expiratory flow rate which is indicative of exercise-induced asthma. Absenteeism and poverty were associated with findings of exercise-induced asthma. Early detection of exercise-induced asthma in school-age children through screening would facilitate early treatment, enhance exercise-related activities, and decreases school absences.

Absenteeism↗