Skip to main content
Top
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Reorganization increases long-term sickness absence at all levels of hospital staff: panel data analysis of employees of Norwegian public hospitals

Author: Mari H Ingelsrud

Published in: BMC Health Services Research | Issue 1/2014

Login to get access

Abstract

Background

The Norwegian specialist health service has undergone many processes of reorganization during the last three decades. Changes are mainly initiated to increase the efficiency and quality of health care serving an ageing population under the condition of a diminishing labour supply. The aim of this study is to investigate the effects of reorganization on long-term sickness absence among different levels of hospital staff.

Methods

The study draws on panel data on employees of Norwegian public hospitals in 2005 and 2007 (N = 106,715). National register data on individual employees’ days of medically certified long-term (>16 days) sickness absence were linked with survey measures of actual reorganization executed at each hospital in each year. The surveys, answered by hospital administration staff, measured five types of reorganization: merging units, splitting up units, creating new units, shutting down units and reallocation of employees. The variation in sickness absence days was analysed using random and fixed effects Poisson regression with level of reorganization as the main explanatory variable.

Results

The fixed effects analysis shows that increasing the degree of organizational change at a hospital from a low to a moderate or high degree leads to an increase in the number of days of long-term sickness absence of respectively 9% (95% CI: 1.03-1.15) and 8% (95% CI: 1.02-1.15). There are few significant differences between employees in different education categories. Only physicians have a significantly higher relative increase in days of long-term sickness absence than the control group with lower tertiary education.

Conclusions

Increased long-term sickness absence is a risk following reorganization. This risk affects all levels of hospital staff.
Literature
1.
go back to reference Møller Pedersen K: Reforming Decentralized Integrated Health Care Systems: Theory and the Case of the Norwegian Reform. 2002, Oslo: Health Economics Research programme (HERO) at the University of Oslo Møller Pedersen K: Reforming Decentralized Integrated Health Care Systems: Theory and the Case of the Norwegian Reform. 2002, Oslo: Health Economics Research programme (HERO) at the University of Oslo
2.
go back to reference Landsbergis PA: The changing organization of work and the safety and health of working people: a commentary. J Occup Environ Med. 2003, 45: 61-72. 10.1097/00043764-200301000-00014.CrossRefPubMed Landsbergis PA: The changing organization of work and the safety and health of working people: a commentary. J Occup Environ Med. 2003, 45: 61-72. 10.1097/00043764-200301000-00014.CrossRefPubMed
3.
go back to reference Vahtera J, Kivimäki M, Pentti J, Linna A, Virtanen M, Virtanen P, Ferrie JE: Organisational downsizing, sickness absence, and mortality: 10-town prospective cohort study. BMJ. 2004, 328: 555-10.1136/bmj.37972.496262.0D.CrossRefPubMedPubMedCentral Vahtera J, Kivimäki M, Pentti J, Linna A, Virtanen M, Virtanen P, Ferrie JE: Organisational downsizing, sickness absence, and mortality: 10-town prospective cohort study. BMJ. 2004, 328: 555-10.1136/bmj.37972.496262.0D.CrossRefPubMedPubMedCentral
4.
go back to reference Westerlund H, Ferrie J, Hagberg J, Jeding K, Oxenstierna G, Theorell T: Workplace expansion, long-term sickness absence, and hospital admission. Lancet. 2004, 363: 1193-1197. 10.1016/S0140-6736(04)15949-7.CrossRefPubMed Westerlund H, Ferrie J, Hagberg J, Jeding K, Oxenstierna G, Theorell T: Workplace expansion, long-term sickness absence, and hospital admission. Lancet. 2004, 363: 1193-1197. 10.1016/S0140-6736(04)15949-7.CrossRefPubMed
5.
go back to reference Østhus S, Mastekaasa A: The impact of downsizing on remaining workers’ sickness absence. Soc Sci Med. 2010, 71: 1455-1462. 10.1016/j.socscimed.2010.06.045.CrossRefPubMed Østhus S, Mastekaasa A: The impact of downsizing on remaining workers’ sickness absence. Soc Sci Med. 2010, 71: 1455-1462. 10.1016/j.socscimed.2010.06.045.CrossRefPubMed
6.
go back to reference Theorell T: Downsizing of staff is associated with lowered medically certified sick leave in female employees. Occup Environ Med. 2003, 60: 9e-10.1136/oem.60.9.e9.CrossRef Theorell T: Downsizing of staff is associated with lowered medically certified sick leave in female employees. Occup Environ Med. 2003, 60: 9e-10.1136/oem.60.9.e9.CrossRef
7.
go back to reference Røed K, Fevang E: Organizational change, absenteeism, and welfare dependency. J Hum Resour. 2007, 42: 156-193.CrossRef Røed K, Fevang E: Organizational change, absenteeism, and welfare dependency. J Hum Resour. 2007, 42: 156-193.CrossRef
8.
go back to reference Østhus S: For better or worse? Workplace changes and the health and well-being of Norwegian workers. Work Employ Soc. 2007, 21: 731-750. 10.1177/0950017007082881.CrossRef Østhus S: For better or worse? Workplace changes and the health and well-being of Norwegian workers. Work Employ Soc. 2007, 21: 731-750. 10.1177/0950017007082881.CrossRef
9.
go back to reference Bambra C, Egan M, Thomas S, Petticrew M, Whitehead M: The psychosocial and health effects of workplace reorganisation. 2. A systematic review of task restructuring interventions. J Epidemiol Community Health. 2007, 61: 1028-1037. 10.1136/jech.2006.054999.CrossRefPubMedPubMedCentral Bambra C, Egan M, Thomas S, Petticrew M, Whitehead M: The psychosocial and health effects of workplace reorganisation. 2. A systematic review of task restructuring interventions. J Epidemiol Community Health. 2007, 61: 1028-1037. 10.1136/jech.2006.054999.CrossRefPubMedPubMedCentral
10.
go back to reference Bernstrom VH, Kjekshus LE: Effect of organisational change type and frequency on long-term sickness absence in hospitals. J Nurs Manag. 2014, Epub ahead of print Bernstrom VH, Kjekshus LE: Effect of organisational change type and frequency on long-term sickness absence in hospitals. J Nurs Manag. 2014, Epub ahead of print
11.
go back to reference Kokkinen L, Virtanen M, Pentti J, Vahtera J, Kivimäki M: Does transfer of work from a public sector organisation to a commercial enterprise without staff reductions increase risk of long-term sickness absence among the staff? A cohort study of laboratory and radiology employees. Occup Environ Med. 2013, 70: 585-587. 10.1136/oemed-2012-101174.CrossRefPubMed Kokkinen L, Virtanen M, Pentti J, Vahtera J, Kivimäki M: Does transfer of work from a public sector organisation to a commercial enterprise without staff reductions increase risk of long-term sickness absence among the staff? A cohort study of laboratory and radiology employees. Occup Environ Med. 2013, 70: 585-587. 10.1136/oemed-2012-101174.CrossRefPubMed
12.
go back to reference Karasek R, Theorell T: Healthy Work. Stress, Productivity, and the Reconstruction of Working Life. 1990, New York: Basic Books Karasek R, Theorell T: Healthy Work. Stress, Productivity, and the Reconstruction of Working Life. 1990, New York: Basic Books
13.
go back to reference Bourbonnais R, Brisson C, Malenfant R, Vézina M: Health care restructuring, work environment, and health of nurses. Am J Ind Med. 2005, 47: 54-64. 10.1002/ajim.20104.CrossRefPubMed Bourbonnais R, Brisson C, Malenfant R, Vézina M: Health care restructuring, work environment, and health of nurses. Am J Ind Med. 2005, 47: 54-64. 10.1002/ajim.20104.CrossRefPubMed
14.
go back to reference Bourbonnais R, Brisson C, Vézina M, Masse B, Blanchette C: Psychosocial work environment and certified sick leave among nurses during organizational changes and downsizing. Ind Relat. 2005, 60: 483-509. Bourbonnais R, Brisson C, Vézina M, Masse B, Blanchette C: Psychosocial work environment and certified sick leave among nurses during organizational changes and downsizing. Ind Relat. 2005, 60: 483-509.
15.
go back to reference Petterson IL, Hertting A, Hagberg L, Theorell T: Are trends in work and health conditions interrelated? A study of Swedish hospital employees in the 1990s. J Occup Health Psychol. 2005, 10: 110-120.CrossRefPubMed Petterson IL, Hertting A, Hagberg L, Theorell T: Are trends in work and health conditions interrelated? A study of Swedish hospital employees in the 1990s. J Occup Health Psychol. 2005, 10: 110-120.CrossRefPubMed
16.
go back to reference Marmot M, Siegrist J, Theorell T: Health and the Psychosocial Environment at Work. Social Determinants of Health. Edited by: Marmot M, Wilkinson RG. 2006, New York: Oxford Marmot M, Siegrist J, Theorell T: Health and the Psychosocial Environment at Work. Social Determinants of Health. Edited by: Marmot M, Wilkinson RG. 2006, New York: Oxford
17.
go back to reference Lippestad JW, Harsvik T, Kjekshus L-E: Ledelse i et Sykehus i Omstilling. En Oppsummering av et Følgeforskningsprosjekt ved Akershus Universitetssykehus i Perioden 2006–2010. [Leadership at a Hospital Under Restructuring. A Summary of an Action Research Project at Akershus University Hospital 2006–2010]. 2011, Oslo: Sintef Lippestad JW, Harsvik T, Kjekshus L-E: Ledelse i et Sykehus i Omstilling. En Oppsummering av et Følgeforskningsprosjekt ved Akershus Universitetssykehus i Perioden 2006–2010. [Leadership at a Hospital Under Restructuring. A Summary of an Action Research Project at Akershus University Hospital 2006–2010]. 2011, Oslo: Sintef
18.
go back to reference Winkleby MA, Jatulis DE, Frank E, Fortmann SP: Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992, 82: 816-820. 10.2105/AJPH.82.6.816.CrossRefPubMedPubMedCentral Winkleby MA, Jatulis DE, Frank E, Fortmann SP: Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992, 82: 816-820. 10.2105/AJPH.82.6.816.CrossRefPubMedPubMedCentral
19.
go back to reference Cameron AC, Trivedi PK: Microeconometrics: Methods and Applications. 2005, New York: Cambridge University PressCrossRef Cameron AC, Trivedi PK: Microeconometrics: Methods and Applications. 2005, New York: Cambridge University PressCrossRef
20.
go back to reference Cameron AC, Trivedi PK: Microeconometrics Using Stata. 2009, Texas: Stata Press, 2 Cameron AC, Trivedi PK: Microeconometrics Using Stata. 2009, Texas: Stata Press, 2
21.
go back to reference Helse- og omsorgsdepartementet [Ministry of health and care services]: Arbeid for Helse. [Working for Health]. 2010, Oslo Helse- og omsorgsdepartementet [Ministry of health and care services]: Arbeid for Helse. [Working for Health]. 2010, Oslo
22.
go back to reference Berg E: På helsa løs; økonomifokuset i norske sykehus. [Negative health effects; the focus on the economy at Norwegian hospitals]. 2012, Oslo: Emilia Berg E: På helsa løs; økonomifokuset i norske sykehus. [Negative health effects; the focus on the economy at Norwegian hospitals]. 2012, Oslo: Emilia
23.
go back to reference Davis JA: A formal interpretation of the theory of relative deprivation. Sociometry. 1959, 22: 280-296. 10.2307/2786046.CrossRef Davis JA: A formal interpretation of the theory of relative deprivation. Sociometry. 1959, 22: 280-296. 10.2307/2786046.CrossRef
24.
go back to reference Steers RM, Rhodes SR: Major influences on employee attendance: a process model. J Appl Psychol. 1978, 63: 391-407.CrossRef Steers RM, Rhodes SR: Major influences on employee attendance: a process model. J Appl Psychol. 1978, 63: 391-407.CrossRef
25.
go back to reference Hofmann B: On the Dynamics of Sickness in Work Absence. Social Aspects of Illness, Disease and Sickness Absence. Edited by: Nordby H, Rønning R, Tellnes G. 2011, Oslo: Unipub Hofmann B: On the Dynamics of Sickness in Work Absence. Social Aspects of Illness, Disease and Sickness Absence. Edited by: Nordby H, Rønning R, Tellnes G. 2011, Oslo: Unipub
26.
go back to reference Marmot M, Feeney A, Shipley M, North F, Syme SL: Sickness absence as a measure of health status and functioning: from the UK Whitehall II study. J Epidemiol Community Health. 1995, 49: 124-130. 10.1136/jech.49.2.124.CrossRefPubMedPubMedCentral Marmot M, Feeney A, Shipley M, North F, Syme SL: Sickness absence as a measure of health status and functioning: from the UK Whitehall II study. J Epidemiol Community Health. 1995, 49: 124-130. 10.1136/jech.49.2.124.CrossRefPubMedPubMedCentral
27.
go back to reference Kjekshus LE, Bernstrøm VH: Helseforetakenes Interne Organisering og Ledelse: INTORG 2009. [The Internal Organization and Leadership of the Health Trusts: INTORG 2009]. 2010, Oslo: Health Economics Research programme (HERO) at the University of Oslo Kjekshus LE, Bernstrøm VH: Helseforetakenes Interne Organisering og Ledelse: INTORG 2009. [The Internal Organization and Leadership of the Health Trusts: INTORG 2009]. 2010, Oslo: Health Economics Research programme (HERO) at the University of Oslo
Metadata
Title
Reorganization increases long-term sickness absence at all levels of hospital staff: panel data analysis of employees of Norwegian public hospitals
Author
Mari H Ingelsrud
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-411

Other articles of this Issue 1/2014

BMC Health Services Research 1/2014 Go to the issue