A Study Of The Association Between Employees' Health Risk Factors And Presenteesim In A Metropolitan Symphony Orchestra

BackgroundHealth is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. Productivity in economics refers to metrics and measures of output from production processes, per unit of input. And health as one of the most important determinants of the human Capital is getting more and more attention. Since 1980s, a lot of studies had explored the relationship between health status of employees and productivity. Presenteeism which is defined as when employees show up for work but, because of mental or medical illness, do not function productively or perform at 100% cost more than absenteeism and disability. Because the interventions of health risk factors are feasible and effective, most of the researcher focused on the relationship between health risk factors and presenteeism , and they all found it. But in China, we have not found a report of the research on the association of the health risk factors and presenteeism.ObjectivesThe objective of our study is to answer the question: Is health risk factors associated with presenteeism in the employees of the symphony orchestra?The relationship between health risk factors and presenteeism is analyzed by addressing several key questions:1. Which health risk factor is associated with presenteeism?2. Is having more total risk factors associated with more presenteeism?3. Is having higher risk level associated with more presenteeism?MethodsOur study is a quasi-experiment. The questionnaire which is modified form the Health Risk appraisal questionnaire of University of Michigan Health Management Research Center, Health and Performance Questionnaire, Work Productivity Short Inventory and Health and Health Questionnaire were sent to 131 employees in the symphony orchestra. According to the distribution of the health risk factors, we designed a 6 months intervention program for the employees in the symphony orchestra. And we also calculate the cost of the presenteeism and absenteeism.Results1.In base line, there were 69.4% employees reported high stress, and 60.3% reported poor perception of physical health, 57.3% reported smoking, 43.8% reported physical inactivity, 38.8% reported high blood pressure, 37.2% reported overweight/obesity. The number of health risk factors employees have ranged from 0 to 8. There are 53 employees (43.8%) in medium level of health risk.After the intervention, the proportion of the 12 health risk factors all reduced. After 3 months, 5 health risk factors declined with statistical significance, they were high blood pressure(P<0.001), poor perception of physical health(P=0.031), overweight/obesity(P=0.021), high cholesterol(P<0.001), job dissatisfaction(P=0.003). After 6months, 3 health risk factors declined with statistical significance, they were high blood pressure(P<0.001), overweight/obesity(P=0.002), high cholesterol (P<0.001).After the intervention, the number of health risk factor also declined from 8 to 6. After 3 months, there were 65.9% of the study group reduced the number of health risk factors, and after 6 months there were 66.7% of the study group reduced the number of health risk factors, with the number of individuals who reduced two or more health risk factors increased, and the number of individuals who gained health risk factors decreased. After the intervention, the average number of health risk factors decreased more than 1.2.In base line, there are 52.1% employees who reported presenteeism, Women (X~2=6.629, P=0.010) , administration Staff (X~2=6.629, P=0.010) ,≤38 age group (X~2=5.873, P=0.016) and the individuals who had a college education (P=0.032) reported more presenteesim.After the intervention, the proportion of the individuals who did not reported presenteeism increased, and the proportion of the individuals who reported high presenteeism decreased. Our study found that after 3 months intervention, the mean value of the Presenteeism declined 3%, after 6 months, declined 2.5%. The average salary of the employees in the symphony orchestra was 6,361 RMB, use this number, we can get that 3 or 6 months intervention can save 159-190RMB for the symphony orchestra from the Presenteeism. 3.The result of the cumulative logit model reflected that high stress was associated with presenteeism (OR=2.266, 95%CI: 1.070-4.799) .We used the cumulative logit model to examine the individuals who reported had Presenteeism, and found that high stress and life dissatisfaction were associated with presenteesim (high stress, OR=7.045, 95%CI: 1.627-30.507; life dissatisfaction, OR=7.229, 95%CI: 1.455-35.921). We also found that the change in physical inactivity was associated with the change in presenteeism(P=0.021). Individuals with high stress reported an average of 5.11% presenteeism compared with 0.95% reported by individuals without stress. Individuals with life dissatisfaction reported an average of 5.11% presenteeism compared with 0.95% reported by individuals without life dissatisfaction. The average salary of the employees in the symphony orchestra was 6,361 RMB, use this number, we can find that the individuals with high stress will cost 265RMB more than individuals without high stress, the individuals with life dissatisfaction will cost 382.3RMB more than individuals without life dissatisfaction. If there were 80 hours in two weeks, the individuals with high stress will loss 3.3 hours more than individuals without high stress, the individuals with life dissatisfaction will loss 3.3 hours more than individuals without life dissatisfaction.We didn't find the relationship between the number of health risk factors and Presenteeism, but we found that individuals who had higher level of health risk had more presenteeism, individuals who reduced one level of health risk will improve their presenteeism 2%.4.Presenteeism will cost 383, 980 RMB per year in the symphony orchestra, which accounted for 54.4%of the total health related cost, Absenteeism will cost 219, 988 RMB per year in the symphony orchestra, which accounted for 31.2% of the total health related cost, and the individual medical insurance will cost 101, 640 RMB per year in the symphony orchestra, which accounted for 14.4% of the total health related cost. Six months health intervention will save 297, 989 RMB for the symphony orchestra, in which presenteeism accounted for 249, 987 RMB , absenteeism accounted for 47, 998 RMB.Conclusions1.High stress, poor perception of physical health, smoking, physical inactivity, high blood pressure and overweight/obesity were the most popular health risk factors in the symphony orchestra. And the rate of high stress, smoking, high blood pressure and overweight/obesity were higher than the general population. Most of the employees in the symphony orchestra were in the level of medium or high. After interventions, the proportion of the 12 health risk factors all reduced and the average number of health risk factors decreased more than 1.The number of individuals who were in the medium or high health risk levels decreased.2. In base line, there are 52.1% employees who reported presenteeism, Women, administration Staff,≤38 age group and the individuals who had a college education reported more presenteesim. After 3 months intervention, the mean value of the presenteeism declined 3%, after 6 months, declined 2.5%. The average salary of the employees in the symphony orchestra was 6,361 RMB, use this number, we can get that 3 or 6 months intervention can save 159-190RMB for the symphony orchestra from the presenteeism.3. High stress and life dissatisfaction were associated with presenteeism, we can get the conclusion that presenteeism is more associated with the perceptual /psychologic health risk factors. The individuals with high stress will cost 265RMB more than individuals without high stress, the individuals with life dissatisfaction will cost 382.3RMB more than individuals without life dissatisfaction. The individuals who had higher level of health risk had more presenteeism, individuals who reduced one level of health risk will improve their presenteeism 2%.4. Presenteeism accounted for 54.4%of the total health related cost, whereas absenteeism accounted for 31.2% of the total health related cost, and the individual medical accounted for 14.4% of the total health related cost. Six months health intervention will save 297, 989 RMB for the symphony orchestra, in which presenteeism accounted for 249,987 RMB, absenteeism accounted for 47,998 RMB.