Sick leave determinants in the healthcare sector (part I): a review of contextual factors

Background: This study aims to describe contextual factors that influence and contribute to sick leave in healthcare, especially in hospital settings. This review would provide a valuable, comprehensive, and evidence-based resource for readers interested in effective human resource management and healthcare or hospital workforce planning. This review referred to studies on the determinants of absenteeism in the healthcare setting.

Methods: To ensure that pertinent papers (2004 – 2022) were identified, a literature search was performed searching Google Scholar, Econ Lit, PubMed, ResearchGate, ScienceDirect, Emerald Insight, Scopus, Medline, PsychInfo, and Web of Science. All abstracts were screened to identify papers that empirically investigated contextual factors of work absence in healthcare populations. A total of 126 papers were initially identified. These were reduced to 61 papers using pre-determined inclusion and exclusion criteria.

Results: Contextual factors such as nature of work, cultural expectations, economic conditions, and seasonality have moderately strong associations with absence. There is a negative relationship between high psychological demands and work-related absenteeism. The key factors associated with sickness absence in healthcare staff were long hours worked, night shifts, changing rostering patterns, work overload and stress, physically demanding roles, poor social support. Other contextual factors such as cultural norms and expectations that support poor attendance reflected strong association with absence levels. Economic conditions are negatively associated with absenteeism as a result of job security fears. Absenteeism is more pronounced during winter and school holidays.

Conclusions: The review concluded that interventions such as screening the prior attendance levels of potential employees would assist greatly in terms of absenteeism rates, while monitoring current absence patterns of existing employees will negate the development of cultural norms in the workplace. Many of the contextual related variables associated with high levels of absenteeism are reducible with the development of screening and monitoring tools.