全髋关节和膝关节置换术前和术后的出勤和旷工情况。
Presenteeism and Absenteeism Before and After Total Hip and Knee Arthroplasty.
机构信息
Center for the Advancement of Value in Musculoskeletal Care, Hospital for Special Surgery, New York, New York; Department of Population Health Sciences, Weill Cornell Medical College, New York, New York.
Center for the Advancement of Value in Musculoskeletal Care, Hospital for Special Surgery, New York, New York; Weill Cornell Medical College, New York, New York.
出版信息
J Arthroplasty. 2021 May;36(5):1511-1519.e5. doi: 10.1016/j.arth.2020.11.024. Epub 2020 Nov 21.
BACKGROUND
Absenteeism is costly, yet evidence suggests that presenteeism-illness-related reduced productivity at work-is costlier. We quantified employed patients' presenteeism and absenteeism before and after total joint arthroplasty (TJA).
METHODS
We measured presenteeism (0-100 scale, 100 full performance) and absenteeism using the World Health Organization's Health and Work Performance Questionnaire before and after TJA among a convenience sample of employed patients. We captured detailed information about employment and job characteristics and evaluated how and among whom presenteeism and absenteeism improved.
RESULTS
In total, 636 primary, unilateral TJA patients responded to an enrollment email, confirmed employment, and completed a preoperative survey (mean age: 62.1 years, 55.3% women). Full at-work performance was reported by 19.7%. Among 520 (81.8%) who responded to a 1-year follow-up, 473 (91.0%) were still employed, and 461 (88.7%) had resumed working. Among patients reporting at baseline and 1 year, average at-work performance improved from 80.7 to 89.4. A Wilcoxon signed-rank test indicated that postoperative performance was significantly higher than preoperative performance (P < .0001). The percentage of patients who reported full at-work performance increased from 20.9% to 36.8% (delta = 15.9%, 95% confidence interval = [10.0%, 21.9%], P < .0001). Presenteeism gains were concentrated among patients who reported declining work performance leading up to surgery. Average changes in absences were relatively small. Combined, the average monthly value lost by employers to presenteeism declined from 15.3% to 8.3% and to absenteeism from 16.9% to 15.5% (ie, mitigated loss of 8.4% of monthly value).
CONCLUSION
Among employed patients before TJA, presenteeism and absenteeism were similarly costly. After, employed patients reported increased performance, concentrated among those with declining performance leading up to surgery.
背景
旷工成本高昂，但有证据表明，与疾病相关的生产力下降（即工作时身体不适）成本更高。我们量化了接受全关节置换术（TJA）前后在职患者的工作时身体不适和旷工情况。
方法
我们使用世界卫生组织的健康和工作表现问卷，在一个方便的在职患者样本中，在 TJA 前后测量了工作时身体不适（0-100 分制，100 分为完全表现）和旷工情况。我们收集了有关就业和工作特点的详细信息，并评估了工作时身体不适和旷工是如何以及在哪些人群中得到改善的。
结果
共有 636 名接受单侧初次 TJA 的患者回复了一封注册电子邮件，确认了就业情况，并完成了术前调查（平均年龄：62.1 岁，55.3%为女性）。有 19.7%的人报告了完全工作表现。在 520 名（81.8%）回复了 1 年随访的患者中，有 473 名（91.0%）仍在工作，有 461 名（88.7%）已恢复工作。在报告基线和 1 年时的患者中，平均工作表现从 80.7 分提高到 89.4 分。Wilcoxon 符号秩检验表明，术后表现明显高于术前表现（P<.0001）。报告完全工作表现的患者比例从 20.9%增加到 36.8%（差值为 15.9%，95%置信区间为[10.0%，21.9%]，P<.0001）。工作时身体不适的改善主要集中在那些术前工作表现下降的患者中。缺勤的平均变化相对较小。综合来看，雇主因工作时身体不适而损失的月价值平均从 15.3%下降到 8.3%，因旷工而损失的月价值从 16.9%下降到 15.5%（即每月损失价值减少了 8.4%）。
结论
在接受 TJA 之前，在职患者的工作时身体不适和旷工成本相似。之后，在职患者报告的工作表现有所提高，主要集中在术前工作表现下降的患者中。
Zotero 插件