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PubMedDate not supplied

Financial impact of health promotion programs: a comprehensive review of the literature.

PURPOSE: The purpose of this review is to summarize the literature on the ability of health promotion programs to reduce employee-related health care expenditures and absenteeism. SEARCH PROCESS: Using key words in a literature-searching program, a comprehensive search was conducted on the following databases: MEDLINE, Embase, HealthSTAR. SPORTDiscus, PsycINFO, SciSearch, ERIC, and ABI Inform. STUDY INCLUSION AND EXCLUSION CRITERIA: All data-based studies that appeared in peer reviewed journals in the English language. Theses, dissertations, or presentation abstracts that were not published in peer reviewed journals were excluded. The initial search identified 196 studies, but only 72 met the inclusion criteria and were included in the review. DATA EXTRACTION METHODS: Summary tables were created that include design classification, subject size, results, and other key information for each study. DATA SYNTHESIS: Both the nature of the findings and the overall quality of the literature were evaluated in an attempt to answer two questions: Do individuals or populations with high health risks have worse financial outcomes than individuals or populations with low health risks? Do health promotion programs improve financial outcomes? MAJOR CONCLUSIONS: There are good correlational data to suggest that high levels of stress, excessive body weight, and multiple risk factors are associated with increased health care costs and illness-related absenteeism. The associations between seat belt use, cholesterol, diet, hypertension, and alcohol abuse and absenteeism and health care expenditures are either mixed or unknown. Health promotion programs are associated with lower levels of absenteeism and health care costs, and fitness programs are associated with reduced health care costs.

Absenteeism↗

PubMedDate not supplied

The association of two productivity measures with health risks and medical conditions in an Australian employee population.

PURPOSE: To investigate the impact of health on job performance using two measures of productivity loss: (1) a self-reported measure of health-related presenteeism and (2) an objective measure of absenteeism. DESIGN: A cross-sectional survey using a Health Risk Appraisal (HRA) to evaluate self-reported presenteeism and the prevalence of 12 health risks and eight medical conditions. SETTING AND SUBJECTS: Employees (n=224) of a private insurance provider in Australia. MEASURES: A Health Risk Appraisal (HRA) questionnaire was used to evaluate self-reported presenteeism on different aspects of job demands and to assess the prevalence of 12 health risks and eight medical conditions. Illness absent hours were obtained from company administrative records. RESULTS: Increased presenteeism was significantly associated with high stress, life dissatisfaction, and back pain, while increased illness absenteeism was significantly associated with overweight, poor perception of health, and diabetes. Excess presenteeism associated with excess health risks (productivity loss among those with medium- or high-risk status compared to those with low-risk status) was independently calculated at 19.0% for presenteeism and 12.8% for illness absenteeism. CONCLUSIONS: This study demonstrates an association between health metrics and self-reported work impairment (presenteeism) and measured absenteeism. The study provides a first indication of the potential benefits of health promotion programming to Australian employees in improving health and to the corporation in minimizing health-related productivity loss.

Absenteeism↗

PubMedDate not supplied

Leprosy control in the post leprosaria abolition years in Nigeria: reasons for default and irregular attendance at treatment centres.

A questionnaire was administered to all patients with leprosy seen at the four leprosy clinics in Anambra State in a face to face interview. The questions covered, among other items, the clinic attendance behaviour and the single most important reason, monthly, for absenteeism in the preceding year. The total and individual frequencies of the reasons for absenteeism were determined for the various behavioural subgroups. The differences in frequencies and associations were analysed. Values of P < 0.05 were considered as significant. The results showed that 27 females and 26 males were interviewed. 39.6% of the patients were irregular attenders 735% were defaulters. Attendance at meetings (P < .001); work at home (P < 0.01) fear/shame/indignation (P < 0.05); no confidence in treatment (P < 0.025) were significant reasons for absenteeism among irregular attenders inter-current illnesses as reasons for absenteeism did not differ significantly between regular and irregular attendees. The association between clinic attendance behaviour and lesion location (revealed Vs concealed) was not statistically significant (X(2)0.3). The findings in this study indicate that in the post leprosaria abolition years, default and irregular clinic attendance by patients with leprosy are numerically large and may compound the problems of control programmes, and thus negate the realization of the global goal of intercepting leprosy transmission.

Absenteeism↗

PubMed1995

"We missed you": the absence that fails to make the heart grow fonder.

Absenteeism is a problem that costs business in general billions of dollars each year. No industry is immune from its impact, least of all health care. The control of absenteeism rests largely in the hands of the first-line supervisor who must demonstrate visible concern for absenteeism and who must faithfully apply the organization's policies in the correction and control of absenteeism. The keys to absence control are visible concern, reliable documentation, consistent policy application across the work group, and constant attention to employee needs and concerns.

Absenteeism↗

PubMed1989

[Is the 1st year in day care so bad?].

The disease incidence in one day care center is analyzed, separating 2 groups, one with child in their first day care center year, and the other with the rest. The absenteeism day is the comparative parameter. The total absenteeism days are 5.62% of the total lecture days, belonging 3.39% to the "old" children and 9.57% to the "new" ones. The total disease number is 713, corresponding 15.05% to the "old" ones, and 37.01% to the "new" ones. The absenteeism days median percentage is 3.27% on the "old" children and 10.5% on the "new". The disease incidence is detailed, distributed in 69.34% of the absenteeism days to the upper respiratory diseases. 9.28% to the lower respiratory diseases, and 5.83% to the gastrointestinal diseases. Each group in month specified.

Absenteeism↗

PubMed1979

Technician losses in public residential facilities.

A cross-organizational longitudinal survey was undertaken of state-operated residential facilities to gauge the extent to which technician-level work forces are affected by turnover and absenteeism. Twelve facilities participated in this study for a period of 9 months. Monthly turnover rates ranged from .6 to 4.9 percent, with a average of 2.4 percent. Turnover rates appeared to be influenced by the size, location, and staffing patterns of the individual institution. With respect to absenteeism, the average "lost time rate" was 6.7 percent. Various standards suggest that absenteeism exceeding 4.5 percent disrupts recommended staffing ratios. One may conclude that employee withdrawal, whether in the form of avoidable turnover or unscheduled absenteeism, represents a serious managerial problem for many institutions.

Absenteeism↗

PubMed1984

Sickness absence in a Singapore refinery.

Most of the literature on sickness absenteeism is derived from western countries where absenteeism is high and has been rising over the years. Less is known of the situation in the newly developing countries of the east. This paper analyses sickness absenteeism in male industrial employees in a major oil refinery in Singapore in 1982. On average each worker had 5.1 spells and 7.0 working days of absence attributed to illness. Absenteeism increased with age, and shift workers were found to have twice as much sick leave as day workers. However more younger workers had longer durations of absence than older workers. This was because chronic medical conditions more commonly associated with increasing age did not contribute significantly to long spells of absence. A variety of surgical operations, followed by accidents, were the main causes of long absences. The absence rate of 7.0 days per worker was much lower than most of the published data from Europe, and was comparable to two shipyards in Singapore.

Absenteeism↗

PubMed1997

Hypertension and sickness absence: the role of perceived symptoms.

The association between perceived symptoms and absenteeism was examined in five groups of employed adults: normotensives, unaware hypertensives, aware and untreated hypertensives, aware and treated hypertensives, and falsely aware normotensives. Aware hypertensives (untreated and treated) and falsely aware normotensives had a higher average of perceived symptoms than normotensives, whereas unaware hypertensives had lower. The absenteeism rate across the groups showed a similar pattern. A significant interaction of perceived symptoms by study group on absenteeism was uncovered. Hypertensives and falsely aware normotensives who reported a low level of symptoms were not absent more than their normotensive counterparts. However, aware hypertensives and falsely aware normotensives who perceived a high symptoms level showed higher absenteeism than unaware hypertensives and normotensives with a similar level. This suggests that aware hypertensives have a greater tendency than both normotensives and unaware hypertensives to equate their symptoms with ill health and to act accordingly. Special attention should be directed to aware hypertensives who perceive a threat to their health.

Adult↗

PubMedDate not supplied

Early identification of patients at risk of developing a persistent back problem: the predictive validity of the Orebro Musculoskeletal Pain Questionnaire.

OBJECTIVE: To test the predictive utility of the Orebro Musculoskeletal Pain Screening Questionnaire in identifying patients at risk for developing persistent back pain problems. DESIGN: Prospective, where participants completed the questionnaire and their cases were followed for 6 months to assess outcome with regard to pain, function, and absenteeism due to sickness. PARTICIPANTS: One hundred seven patients, recruited from seven primary care units. RESULTS: Discriminant analyses showed that the items on the questionnaire were significantly related to future problems. For absenteeism due to sickness, 68% of the patients were correctly classified into one of three groups, whereas an even distribution would have produced 33%. The analyses for function correctly classified 81%, and for pain 71%, into one of two groups, compared with a chance level of 50%. A total score analysis demonstrated that a cutoff score of 90 points had a sensitivity of 89% and a specificity of 65% for absenteeism due to sickness, and a sensitivity of 74% and a specificity of 79% for functional ability. CONCLUSIONS: The results underscore that psychological variables are related to outcome 6 months later, and they replicate and extend earlier findings indicating that the Orebro Screening Questionnaire is a clinically reliable and valid instrument. The total score was a relatively good predictor of future absenteeism due to sickness as well as function, but not of pain. The results suggest that the instrument could be of value in isolating patients in need of early interventions and may promote the use of appropriate interventions for patients with psychological risk factors.

Acute Disease↗

PubMed1997

Effect of exercise on sick leave due to low back pain. A randomized, comparative, long-term study.

STUDY DESIGN: The study was carried out as an open, randomized, multicenter, parallel-group study with an observation period of 12 months. Four norwegian physiotherapy institutes took part. Patients were subsequently followed for 12 months of home exercise on their own, without for 12 months of home exercise on their own, without the supervision of a physiotherapist. OBJECTIVES: 1) To investigate and compare the effects of two different exercise programs on low back problems in patients after a 1-year training program under the supervision of a physiotherapist. 2) To investigate the effect supervision by, and motivation from, physiotherapists has on training compliance and efficacy. SUMMARY OF BACKGROUND DATA: After ordinary physiotherapy treatment for low back problems, patients were randomly allocated either to a conventional training program designed by physiotherapists or to a training program using a new Norwegian-developed training apparatus called the TerapiMaster. The study included 153 patients with low back problems, all of whom had been referred to physiotherapy by their general practitioners. One hundred twenty-six patients were followed for an additional 12 months when performing home exercise programs on their own. METHODS: Monitoring patient satisfaction with the training program, compliance with the program, and absenteeism from work during the training period. RESULTS: Patient satisfaction with both training programs was high, with about 83% of participating patients completing the study in accordance with the protocol. Mean absenteeism (SD) during the preceding year totaled 82.5 days (19.8) in the conventional training group and 61.6 days (14.7) in the TerapiMaster group. Significant reductions to 17.2 days (6.0) and 16.4 days (5.3) in the two groups, respectively, were recorded during the training period, corresponding to a 75% to 80% reduction compared with the preceding 1-year period. Mean absenteeism showed a further significant decline during the 12-month period without supervised training. The average values were 9.9 days (3.2) for conventional training and 9.3 days (3.1) for the TerapiMaster, respectively. CONCLUSIONS: Both exercise programs reduced absenteeism significantly (75-80%). No difference in the effects of the two different programs was discernible. Regular follow-up through encouragement and variation in the training programs appear to be important factors for motivating patients to adhere to regular exercise programs for low back problems. This thesis was corroborated by the 12-month study of unsupervised exercise.

Adult↗

PubMed1989

The cost of diabetes.

This paper estimates the cost of diabetes in England and Wales in 1984 to be in excess of 259.5 million pounds. The costing methodology used follows the 'cost of illness' framework. This framework defines three elements for costing: direct, indirect and psychological, although the latter element is left out of the calculation because monetary valuations for this element have never been adequately estimated. Direct costs include resources used to prevent, detect, and treat diabetes. Indirect costs relate to the loss of productive output caused by absenteeism, early retirement, and premature mortality. The estimate which has been obtained is likely to be an underestimate because of the weaknesses and gaps in the data sets. The estimate of the total lost earnings from diabetes varied greatly according to the choice of absentee rate. If there was no significant difference between absenteeism in the diabetic community and the non-diabetic community then the cost of diabetes would be 259.5 million pounds. If on the other hand the diabetic community was prone to three times as much absenteeism as the non-diabetic community then the cost of diabetes would rise to 602.5 million pounds. The costs of diabetes as a subsidiary diagnosis are extremely difficult to identify. They have been estimated in this study to be 86 million pounds but this is thought to be an overestimate. Nevertheless the cost of diabetes is significant and thus the search for more efficient treatment regimens may reduce such costs as well as enhance the quality of life of the patients concerned.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMed2000

How do types of employment relate to health indicators? Findings from the second European survey on working conditions.

STUDY OBJECTIVE: To investigate the associations of various types of employment with six self reported health indicators, taking into account the part played by demographic variables, individual working conditions and four ecological indicators at the country level. DESIGN: Cross sectional survey (structured interview) of a sample of the active population of 15 European countries aged 15 years or over. Main independent variables were nine types of employment categorised as follows: small employers, full and part time permanent employees, full and part time fixed term employees, full and part time sole traders and full and part time temporary contracts. Main outcome measures were three self reported health related outcomes (job satisfaction, health related absenteeism, and stress) and three self reported health problems (overall fatigue, backache, and muscular pains). Logistic regression and multilevel models were used in the analyses. SETTING: 15 countries of the European Union. PARTICIPANTS: 15 146 employed persons aged 15 or over. MAIN RESULTS: Precarious employment was consistently and positively associated with job dissatisfaction but negatively associated with absenteeism and stress (as compared with full time permanent workers). Fatigue, backache and muscular pains also tended to be positively associated with precarious employment, particularly with full time precarious employment. Small employers reported high percentages of stress and fatigue, but absenteeism was relatively low. Sole traders generally reported high percentages of all outcomes, except for absenteeism, which was low. For each type of employment (except temporary contracts), full time workers tended to report worse health outcomes than part time workers. Patterns were generally consistent across countries. Associations persisted after adjustment for individual level working conditions and were not modified by country level variables. CONCLUSIONS: This study is the first to examine the relations between various types of employment and six health related indicators for all 15 member states of the European Union. Suggestive patterns worthy of further exploration have been found. Standardised definitions of types of underemployment and health related outcomes, more potent epidemiological designs and the inclusion of socioeconomic information (for example, social security systems, incapacity benefit schemes) at the regional level are proposed for inclusion in further research.

Adolescent↗

PubMedDate not supplied

Application of Karasek's demand/control model a Canadian occupational setting including shift workers during a period of reorganization and downsizing.

PURPOSE: To apply Karasek's Job Content Model to an analysis of the relationships between job type and perceived stress and stress behaviors in a large company during a period of reorganization and downsizing. DESIGN: Cross-sectional mail-out, mail-back survey. SETTING: A large Canadian telephone/telecommunications company. SUBJECTS: Stratified random sample (stratified by job category) of 2200 out of 13,000 employees with a response rate of 48.8%. MEASURES: Responses to 25 of Karasek's core questions were utilized to define four job types: low-demand and high control = "relaxed"; high demand and high control = "active"; low demand and low control = "passive", and high demand and low control = "high strain." These job types were compared against self-reported stress levels, perceived general level of health, absenteeism, alcohol use, exercise level, and use of medications and drugs. Similar analyses were performed to assess the influence of shift work. RESULTS: Employees with "passive" or "high strain" job types reported higher levels of stress (trend test p < .0001); poorer health (trend test P = .006); and higher levels of absenteeism (trend test p < .0001). More shift workers reported themselves in poor or fair health (chi-square p = .018) and reported high levels of stress at home (chi-square p = .002) than nonshift workers. The relationships between job type and levels of stress, health and absenteeism, however, held for nonshift workers as well. CONCLUSIONS: Job types with high demand and low control were associated with increased stress, increased absenteeism, and poorer self-concept of health. The demand/control model of Karasek and Theorell was validated in this setting with respect to stress and some stress-associated attitudes and behaviors.

Adult↗

PubMed1998

A study of low clinic attendance of leprosy patients: reasons and solutions.

In this study, the effect of health education on a sample of 325 absentee leprosy patients was assessed in a leprosy endemic area. About 46% of the absentees from the study group returned to the clinic following health education (HE). HE was more effective amongst those who defaulted in the later part of their treatment sessions. Monthly attendance rate increased from 70%-74% to 72%-91% following HE. Amongst the absentees, 58% were absent due to personal reasons and 8% due to health service related reasons. Personal reasons was the commonest cause for absenting at second pulse. At third pulse it was due to socio-economic reasons. At fourth pulse it was due to service-related reasons. At fifth pulse the commonest reason was disease-related. Health education had proved to be a definite solution to solve the absentee problem.

Adult↗

PubMedDate not supplied

[Psychogenesis of accidents].

After having carried out a historical review of industrial psychology with specific attention to the evolution of the concept of causality in accidents, the Authors formulate their work hypothesis from that research which take into highest consideration the executives' attitudes in the genesis of the accidents. As dogmatism appears to be one of the most negative of executives' attitudes, the Authors administered Rockeach's Scale to 130 intermediate executives from 6 industries in Latium and observed the frequency index for accidents and the morbidity index (absenteeism) of the 2149 workhand. The Authors assumed that to high degree of dogmatism on the executives' side should correspond o a higher level of accidents and absenteeism among the staff. The data processing revealed that, due to the type of machinery employed, three of the industries examined should be considered as High Risk Industrie (HRI), while the remaining three could be considered as Low Risk Industries (LRI): in fact, due to the different working conditions, a significant lower number of accidents occurred in last the three. A statistically significant correlation between the executives' dogmatism and the number of accidents among their workhand in the HRI has been noticed, while this has not been observed in the LRI. This confirms, as had already been pointed out by Gemelli in 1944, that some "objective conditions" are requested so that the accident may actually take place. On the other hand the morbidity index has not shown any difference related to the different kind of industries (HRI, LRI): in both cases statistically significant correlations were obtained between the executives' dogmatism and the staff's absenteeism. absenteeism.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Occupational↗

PubMed1997

[Musculoskeletal problems and physical activity. Results from a long-term study].

In two Norwegian industrial companies 42 employees (24 female/18 male) with shoulder, neck and back problems took part in a training programme for a period of 12 months. The programme comprised of daily relaxation exercises at work combined with training at home three times a week for about 30 minutes on each occasion. The physical therapy and training apparatus, TerapiMaster, which was constructed in Norway was used both at work and at home. The training programme was developed and monitored by an experienced physiotherapist. The observations of the training programme focused on changes in absenteeism during the training period compared with pre-study absenteeism. For employees with musculo-skeletal ailments the combination of relaxation exercises and physical training with professional instruction and follow-up significantly reduced absenteeism from 11.2 days per year (pre-study) to 0.2 days per year (at the end of the 12-month training period) (p < 0.001). A follow-up 30 months after completion of the formal study showed that absenteeism remained at the reduced rate, probably because positive experiences and "good habits" developed during the study encouraged the participants to continue with the training programme.

Adult↗

PubMed2000

Prevalence and impact of dysmenorrhea on Hispanic female adolescents.

BACKGROUND: Dysmenorrhea is the leading cause of short-term school absenteeism. It is associated with a negative impact on social, academic, and sports activities of many female adolescents. Dysmenorrhea has not previously been described among Hispanic adolescents, the fastest growing minority group in the United States. OBJECTIVE: To determine the prevalence of dysmenorrhea among Hispanic female adolescents; its impact on academic performance, school attendance, and sports and social activities; and its management. PARTICIPANTS AND METHODS: A total of 706 Hispanic female adolescents, in grades 9 through 12, completed a 31-item questionnaire about the presence, duration, severity, treatment, and limitations of dysmenorrhea at a local urban high school. RESULTS: Among participants who had had a period in the previous 3 months, 85% reported dysmenorrhea. Of these, 38% reported missing school due to dysmenorrhea during the 3 months prior to the survey and 33% reported missing individual classes. Activities affected by dysmenorrhea included class concentration (59%), sports (51%), class participation (50%), socialization (46%), homework (35%), test-taking skills (36%), and grades (29%). Treatments taken for dysmenorrhea included rest (58%), medications (52%), heating pad (26%), tea (20%), exercise (15%), and herbs (7%). Fourteen percent consulted a physician and 49% saw a school nurse for help with their symptoms. Menstrual pain was significantly associated with school absenteeism and decreased academic performance, sports participation, and socialization with peers (P<.01). CONCLUSIONS: Dysmenorrhea is highly prevalent among Hispanic adolescents and is related to school absenteeism and limitations on social, academic, and sports activities. Given that most adolescents do not seek medical advice for dysmenorrhea, health care providers should screen routinely for dysmenorrhea and offer treatment. As dysmenorrhea reportedly affects school performance and attendance, school administrators may have a vested interest in providing health education on this topic to their students. Arch Pediatr Adolesc Med. 2000;154:1226-1229.

Absenteeism↗

PubMed2000

Nocturnal asthma in children affects school attendance, school performance, and parents' work attendance.

CONTEXT: Asthma symptoms that occur at night may signal worse asthma control, but the nighttime occurrence may have additional clinical significance. To date, however, there have been few studies of the impact of nocturnal awakening from asthma on children with the disease, including problems with daytime functioning. OBJECTIVE: To determine if school absenteeism and school performance in children and work absenteeism in their parents are associated with nocturnal awakenings from asthma. DESIGN: Cross-sectional survey during the winter of 1997 through 1998. SETTING: Three managed care organizations in the United States. PARTICIPANTS: Parents of 438 children with asthma, aged 5 to 17 years, who were enrolled in managed care organizations. INTERVENTION: None. MAIN OUTCOME MEASURES: Parent's reports of number of days their child missed school and parent missed work and how often the child's education suffered because of asthma in the past 4 weeks. RESULTS: Overall, more than 40% of children had nocturnal awakenings from asthma in the past 4 weeks. Multivariate analyses were performed that adjusted for child age, race, overall symptom severity, and use of reliever medications. Compared with children who did not awaken from asthma, there were greater odds of missed school days in children who awakened 1 to 3 nights (odds ratio [OR], 3.6; 95% confidence interval [CI], 2.1-6.2), 4 to 7 nights (OR, 4.4; 95% CI, 2.0-10.0), and more than 7 nights (OR, 14.7; 95% CI, 5.9-37.0). Similarly, there were greater odds of education suffering in children who awakened 1 to 3 nights (OR, 2.3; 95% CI, 1.4-3.7), 4 to 7 nights (OR, 2.1; 95% CI, 0.9-4.6), and more than 7 nights (OR, 2.3; 95% CI, 1. 0-5.4), and parents missing work in children who awakened 1 to 3 nights (OR, 4.0; 95% CI, 2.2-7.1), 4 to 7 nights (OR, 6.5; 95% CI, 2.7-16), and more than 7 nights (OR, 3.2; 95% CI, 1.3-7.9). Greater overall symptom severity and high use of reliever mediation were also associated with missed school, education suffering, and parent absenteeism. CONCLUSIONS: Nighttime awakenings in children with asthma may affect school attendance and performance, as well as work attendance by parents. Nighttime symptoms have independent prognostic value, even when overall asthma symptom severity is accounted for. By addressing whether there are nighttime awakenings in children with asthma, clinicians may be able to tailor the therapeutic regimen to counter these symptoms.

Absenteeism↗