Theoretical Analysis And Empirical Research On Presenteeism Among Doctors And Nurses In China

Presenteeism refers to attending work while sick.Same as absenteeism,presenteesim is also a workplace behavior caused by health-related problems.Evidence indicates that presenteeism could lead to much more economical cost than that ascribed to absenteeism.However,as its negative impacts are not obvious,presenteeism has not gained enough attention and the research on it is far behind absenteeism.Only from the 1990 s,presenteesim has become a subject of interest.The study of presenteeism started in Europe and America and has been gaining more and more attention there.However,the related research is rare in China and has not showed obvious progress.In terms of subject perspectives,the existing research could be classified into epidemiology or occupational health persepective and management persepective.The former persepective has accumulated relatively more studies,concerned about which health problems or health risk factors have impacts on work productivity;the studies from management perspective are concerned with the individual and organizational factors which could affect the emplyees' decisions on “being present or being absent” while they are sick.So far,the empirical studies of presenteeism in China are all from epidemiology or occupational health persepective.This study is the first empirial study of presenteeim which was designed and analized from both labor ecomomics and organitional management perspectives and conducted on a national scale in China.The research is targeted at doctors and nurses in China,with the purpose of revealing its prevalence of presenteeism and its causes and consequences,mainly from the perspective of labor economics and organizational management.Based on the literature review and theoretical analysis,the model of "formation and reaction of presenteeism" was proposed,and the questionnaire survey was designed and conducted at three stages: field test,pilot test and final survey.At stage of final survey,a valid sample of 1023 was obtained,covering 29 provinces(municipalities/autonomous regions).The main conclusions of this survey include: first,presenteeism is prevalent among doctors and nurses in China.79.2% of the respondents reported at least once presenteeism in the 6-month recall period,and 55.0% of the respondents reprorted two or more times of presenteeism.Presenteeism is more common among doctors than among nurses,and a greater proportion of doctors experience higher frequency of presenteeism than nurses do.Second,presenteeism among doctors and nurse could result in great productivity impairment.Measured by the Stanford Presenteeism Scale(SPS-6)and the Work Productivity and Activity Impariment Questionnaire(WPAI-GI),the productivity level of respondents while they were experiencing presenteeism only reached about two-thirds of their normal levels;the percentage of productivity loss is as high as 33.41%±28.35%;and the unproductive time caused by presenteeism was 26 times more than that caused by sickness absent;doctors had a slightly higher rate of productivity loss ascribed to presenteeism than nurses did.Third,"personal factors" and "organizational context factors" not only affect the employees' decisions on whether they choose to attend work or stay at home while sick,but also have impacts on the extent of productivity loss ascribed to presenteeism.The reasons that the respondents chose to work while sick,were mainly due to the concern of the possible negative effects on the organizational interests,rather than the concern of their individual interests.Health problems are the root causes of presenteeism,and the current health status of doctors and nurses in China is not optimistic.Of all the respondents,only 18.3% reported that they were on a "good" or "very good" health level,while 29.4% self-rated as "poor" or "very poor".The worse the self-reported health status is,the higher the frequency of presenteeism is and the greater the loss of productivity is.As the self-reported health status drops from one level to the next lower level,the percentage of productivity loss ascribed to presenteeism rises by about 5%~14%.To a certain extent,the results of the empirical survey also verify the rationality behind the "formation and reaction of presenteeism" model.Finally,measures on how to manage presenteesim from an organizational aspect are recommended.Although at the level of hospital,it is unable to fundamentally solve the problems such as medical staff-patient imbalance,staff shortages,there are still some adjustments could be made inside of the hospital,which could reduce the frequency of presenteeism and its negative influences.