Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark.
Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
Occup Environ Med. 2018 Jul;75(7):479-485. doi: 10.1136/oemed-2017-104865. Epub 2018 May 14.
We investigated work-unit exit, total and long-term sickness absence following organisational change among public healthcare employees.
The study population comprised employees from the Capital Region of Denmark (n=14 388). Data on reorganisation at the work-unit level (merger, demerger, relocation, change of management, employee layoff or budget cut) between July and December 2013 were obtained via surveys distributed to the managers of each work unit. Individual-level data on work-unit exit, total and long-term sickness absence (≥29 days) in 2014 were obtained from company registries. For exposure to any, each type or number of reorganisations (1, 2 or ≥3), the HRs and 95% CIs for subsequent work-unit exit were estimated by Cox regression, and the risk for total and long-term sickness absence were estimated by zero-inflated Poisson regression.
Reorganisation was associated with subsequent work-unit exit (HR 1.10, 95% CI 1.01 to 1.19) in the year after reorganisation. This association was specifically important for exposure to ≥3 types of changes (HR 1.52, 95% CI 1.30 to 1.79), merger (HR 1.29, 95% CI 1.12 to 1.49), demerger (HR 1.41, 95% CI 1.16 to 1.71) or change of management (HR 1.24, 95% CI 1.11 to 1.38). Among the employees remaining in the work unit, reorganisation was also associated with more events of long-term sickness absence (OR 1.15, 95% CI 1.00 to 1.33), which was particularly important for merger (OR 1.31, 95% CI 1.00 to 1.72) and employee layoff (OR 1.31, 95% CI 1.08 to 1.59).
Specific types of reorganisation seem to have a dual impact on subsequent work-unit exit and sickness absence in the year after change.
我们调查了公共医疗保健员工在组织变革后的工作单位离职、总病假和长期病假情况。
研究人群包括丹麦首都大区的员工（n=14388）。2013 年 7 月至 12 月期间，通过向每个工作单位的经理分发调查，获取了有关工作单位层面的重组（合并、拆分、搬迁、管理层变更、员工下岗或预算削减）的数据。2014 年，通过公司登记册获取了个人层面的工作单位离职、总病假（≥29 天）和长期病假（≥29 天）的数据。对于暴露于任何、每种或多种重组（1、2 或≥3），通过 Cox 回归估计随后的工作单位离职的 HR 和 95%CI，通过零膨胀泊松回归估计总病假和长期病假的风险。
重组与重组后一年的工作单位离职（HR 1.10，95%CI 1.01 至 1.19）相关。这种关联对于暴露于≥3 种类型的变化（HR 1.52，95%CI 1.30 至 1.79）、合并（HR 1.29，95%CI 1.12 至 1.49）、拆分（HR 1.41，95%CI 1.16 至 1.71）或管理层变更（HR 1.24，95%CI 1.11 至 1.38）尤其重要。在留在工作单位的员工中，重组也与长期病假事件增多相关（OR 1.15，95%CI 1.00 至 1.33），这对于合并（OR 1.31，95%CI 1.00 至 1.72）和员工下岗（OR 1.31，95%CI 1.08 至 1.59）尤为重要。
特定类型的重组似乎对变革后一年内的工作单位离职和病假有双重影响。
