Sick leave determinants in the healthcare sector (part II): a review of organizational-level factors

Background: Organizational level factors may influence and contribute to sick leave in healthcare, and particularly hospital, settings. We utilize relevant publications from recent literature to provide a useful, comprehensive and evidence-based resource for readers interested in effective human resource management and healthcare or hospital workforce planning.

Methods: To ensure that pertinent papers (2004 – 2022) were identified, a systematic literature review was performed searching Google Scholar, Econ Lit, PubMed, ResearchGate, ScienceDirect, Emerald Insight, Scopus, Medline, PsychInfo, and Web of Science databases. All abstracts were screened to identify papers that empirically investigated organizational level factors relevant to sickness absence in a healthcare population. A total of 452 papers were initially identified. These were reduced to 133 papers using pre-determined inclusion and exclusion criteria.

Results: Key factors associated with sickness absence in healthcare staff were long hours worked, work overload, working conditions and stress, and the effects of these on personal lives; job control including lack of participation in decision making; poor social support. Other organizational-level factors such as size and type of organization reflected strong association with absence levels. Shorter distance from work and seniority of position are reported to have a strong negative association with absenteeism. Management leadership style and workload were not found to be determinants.

Conclusions: Interventions that improved psychological health and levels of sickness absence used training and organizational approaches to increase participation in decision making and problem solving, increase support and feedback, and improve communication. Many of the work-related variables associated with high levels of psychosocial factors are potentially amenable to change.