Employee Absenteeism In Primary Healthcare Essay


Discuss about the Employee Absenteeism In Primary Healthcare.



The word absenteeism means unscheduled absences. In the health care section, the word absenteeism refers to the medical staffs that include particularly nurses in settings of health cares which gives rise to continual strain and also affects the quality services of the health care that are received by their patients (Nelson et al., 2014). The ability of the health care also gets affected by absenteeism that mainly deals effectively with the challenges that comes from the factors of environment and also has a great effect for all the functions that are carried out in the organization of the health care. There should be ample number of nurses and doctors in all heath centers and clinics or in hospitals so that all the patients are attended with outmost care and they can give quality services to their patients. The providers of health care stands as a backbone to any organization of health care to deliver their systems (Kocakulah et al., 2016). There must be adequate number of nurses for addressing properly the heath and care needed by their patients and also serve their country well. The challenge that is faced by the health cares is number of absenteeism among the nursing staffs.

In this report, detailed is discussed about the reason of absenteeism mostly in health care organizations. Secondary data are collected in literature review from various literatures describing the reason behind absenteeism. The factor that influences absenteeism in health care are also discussed elaborately. This report also sheds light on the challenges that are faced by the absence management while controlling the sickness absence in an organization of health care or personal clinics.

Conceptual Framework

Absenteeism of employees is one of the most important and critical issue that is mostly faced by the health care sectors. The reason for increasing the absenteeism is absence management in organizations and health care sectors. The reason for the absenteeism in organization happens due to various factors. Absences of employees can cause disruptive in businesses and also can cost high to the organization. The managers who are involved in the management have to mainly understand the main cause behind absenteeism and then implement the strategies for managing them. The main aim of this research is to find reason behind absenteeism of employees in health sector is mainly studied in this report. The reasons are elaborately studied in this research and how to overcome those are also discussed in this research paper.

Figure 1: Mind Map

Research Questions

  • How the employee absenteeism affects the absence management in health sector?
  • What are the recommendation of the effectiveness of absence management to reduce Absence in health cares?

Literature Review

According to (Durand et al., 2014), absenteeism can be defined as involuntary absence that occurs due to some reasons that are not in control of the employees and the voluntary absence involves absence that occurs when an employee makes his own decision for not to go for their work. Zuo & Zhao (2014), stated that it is difficult to differentiate between involuntary absence and voluntary absence in an organization. The only way to distinguish between them is the frequency assessment and also duration of leave that has been taken by the employee. If the frequency of the absence is high, then it is regarded as voluntary absence and if the frequency of leave has low frequency, then it is considered as involuntary absence. Voluntary absence is considered as an unplanned absence and it is also termed as short termed leave. As stated by (Swink et al., 2014), according to perspective of a system, there are many different factors that influences absenteeism to influence absence among the health workers in an organization of health care. The factors involved mainly are categorized in three sectors: content or workplace factor, cultural and organizational factor and also personal factor.

There can be absenteeism due to employment sector. There can be absenteeism due to high as well as low setting of resources in a public organization such as hospitals and health care organization. (Gosselin, Lemyre & Corneil, 2013) found in an research study that in a health sector in Costa Rica, the number of absenteeism is increasing in the health organizations which is not often addressed in the frameworks of health systems. The size of the health care can also influence the number of absenteeism. There is an argument that organizations that are large have minimum group cohesiveness, efforts of individual goes unnoticed and also has greater bureaucracy. Kristman et al. (2016) stated by doing an evaluation on the impact of the changes that takes place in health care sectors due to organizational reforms and reimbursement methods mainly on absenteeism. They evaluated that the number of absenteeism is increasing day by day in large hospitals with comparison to smaller ones. In Kenya, (Daouk-?yry et al., 2014) it was reported that employees of hospitals in sub-districts and main districts were more absent than the employees in health centers and small dispensaries. The reason for absenteeism may also come from the location of facility of the heath care. The health care is in rural or urban place also decides the percentage of absenteeism in health care centers. The absence rate also depends on the area where the workers live and their distance to hospitals. (Kangas et al., 2017) considered that in a country like Nigeria, the number of absenteeism in rural areas should be more because of the irregular transport problem and the workers of the hospitals and dispensaries had to travel further distances. But the actual situation was totally different according to (Johnson et al., 2014). They found that hospitals in urban areas have more absenteeism compared to rural areas.

Challenges Faced by Absence Management

Absence due to sickness is mainly considered as a context of macro-economic factor that is needed to lessen the societal cost and also helps in effective allocation of the resources (Jones & Killion, 2017). There is much little evaluation for the absentees due to sickness because personal consequences are not at all well-defined. The managers of the absence management are mainly responsible to control the absence of the organization (Keasberry et al., 2017). The managers have to implement certain strategies that help to control the absence rate in the workplace. Also, there should be good understanding to carry out the role in all these processes. It is relevant to managers to include all the stakeholders under the policies that are stated by the management (Loke et al., 2015). The managers have to understand their positions and are expected to implement practices and policies in the organization of healthcare. If their positions are not understood properly, then there may arise a potential complication among the managers of the organization of health sectors.

Effectiveness of Managers in Reducing Absence

There are many strategies that are explored by researchers that effects in reducing the percentage of absence among the staffs of health care. The managers play a proactive role in managing the absence due to sickness (Zboril-Benson, 2016). The managers can make the employees feel valuable to the organization which can decrease the rate of absenteeism in organization of health cares. The managers can maintain the absence rate in many ways. The management can keep a touch with all its employees who are in leave because of sickness for planning the adjustment to make a quick return to the work. According to (Zingg et al., 2015), absence that lasts for less than 28 days are considered as short-term absence. The patterns of absences are mostly evaluated in short-term absences. The managers who are effective in their work mainly encourage the individuals to take off when they face difficulties and discomforts. This approach of the manager is considered as a key message in sickness absence management. Tracking of presence is also considered as imperative.

It is also necessary for the managers of absence management to review history of all the absences that takes place in the organization. This is mainly done to view whether the pattern of absence of a particular nursing staff improves or the pattern gets worse (Engel et al., 2014). The managers are to be given relevant training so that they are capable of identifying the changes in the behavior of their staffs. The way by which managers get to know whether the problems that are involved for sickness absence are genuine or not is only by their experience. The employee welfare should also be noticed to reduce absence due to sickness in an organization.

Project Execution Plan

Y?ld?z et al. (2015) illustrated the data that were interviewed face to face in a health care of Turkey. A questionnaire session was held by (Nelson et al, 2014), in between the employees who aged between 19 years to 50 years. Almost 168 employees of healthcare were questioned where it was found that employees who were absent more than two times for the reason of illness in last one year was about 32. The working hours of the employees were also less than the actual time as stated in (Vossen & van Gestel, 2015). Allover, the percentage of absenteeism was about 32% after surveying the employees. The employees that were surveyed were mostly monthly paid.

The research that was conducted by (Belita, Mbindyo & English, 2013), considered presenteeism and absenteeism as an outcome variable and the efficiency and working hours are considered as predictor variables. Bothe the outcome variables and the predictor variables are constructed well from the research that was conducted. (Fagan et al., 2014) also considered some controlled variables that include job, education, workers, gender, working experience, age and many more.

Project Schedule and Gantt Chart

Task Name




Research Project

101 days

Mon 05-02-18

Mon 25-06-18

Proposal development

11 days

Mon 05-02-18

Mon 19-02-18

Selection of the topic for the research project

2 days

Mon 05-02-18

Tue 06-02-18

Preparing the layout for proposal

4 days

Wed 07-02-18

Mon 12-02-18

Design the research proposal

5 days

Tue 13-02-18

Mon 19-02-18

Submission of the proposal

0 days

Mon 19-02-18

Mon 19-02-18

Complete research work

90 days

Tue 20-02-18

Mon 25-06-18

Literature Review

42 days

Tue 20-02-18

Wed 18-04-18

Developing the proper methodology for research

9 days

Thu 19-04-18

Tue 01-05-18

Identification of proper sources for the secondary data

5 days

Wed 02-05-18

Tue 08-05-18

Collection of the secondary Data

10 days

Wed 09-05-18

Tue 22-05-18

Analysis of the Data

6 days

Wed 23-05-18

Wed 30-05-18

Collection of findings from the analysis

6 days

Thu 31-05-18

Thu 07-06-18

Drawing conclusions from the study

5 days

Fri 08-06-18

Thu 14-06-18

Preparation of rough draft for the study

4 days

Fri 15-06-18

Wed 20-06-18

Review of the work

3 days

Thu 21-06-18

Mon 25-06-18

Final submission

0 days

Mon 25-06-18

Mon 25-06-18

Table 1: (Project Schedule)

(Source: Created by Author)

Gantt Chart

Figure 2: (Gantt Chart)

(Source: Created by author)

Data Sources




Outcome Variable


Person has been absent two or more times because of illness during the past 12 mo = 1, otherwise = 0



Person has been present two or more times while sick during the past 12 mo = 1, otherwise = 0


Predictor Variables Policy Variables

Working hr match

Desired and actual weekly working hr match exactly = 1, otherwise = 0


Efficiency demands

In tough situations efficiency rules out everything else in firm, according to the survey respondent = 1, otherwise = 0


Control Variables


Male = 1

Female = 0



Age (yr)

18-35 = 1

>35 = 0




Doctor/Dentist = 1, otherwise = 0 (reference)

Nurse/Midwife = 1, otherwise = 0

Health Technician = 1, otherwise = 0





Health College/Associate Degree = 1, otherwise = 0 (reference) Undergraduate Degree = 1, otherwise = 0

Postgraduate Degree = 1, otherwise = 0




Occupational Experience (yr)

1-10 = 1, otherwise = 0 (reference)

11-20 = 1, otherwise = 0

>20 = 1, otherwise = 0





Replacement is not possible = 1, otherwise = 0 (reference)

Replacement is possible by substitutes = 1, otherwise =0

Replacement is possible by colleagues = 1, otherwise = 0




Additional Payments

Additional payments are cut back when employees has been absent = 1, otherwise = 0

Additional payments are not cut back when employees has been absent = 1, otherwise = 0





Note- Those who have never been or once absent (present while sick) during the last 12 months are marked as zero and those who have been absent (present) two or more times as one. This gives a prevalence of 32% for absenteeism and 65% for presenteeism

Table 2: Showing data for Turkey Health Cares

Sl. No.








Table 3: (Data Links)


The sector of health care and social well-being is mainly considered as inherent demand of the patients. The organization of health care focuses more on patients than the service providers of their heath cares. The employees have duty to provide a good service to all their patients without the support of the staffs in management. The phenomenon of being absent mainly affects the morale of their duties and services. Absenteeism gives rise to stress in workplace. The other staffs of nursing also faces problems by absenteeism of other staffs and the patients are not served properly. Absenteeism gives low satisfactory level in healthcare sectors that are associated with all the working conditions, unfairness, and personal reasons of the services that are provided to the patients. The qualities of the services that are given to the patients are mostly negatively affected by the escalation of the absenteeism in organizations of health cares. This research has a detailed study of the reason of absenteeism in health cares and the way to mitigate the percentage of absenteeism by the absence management. The assessment that is analyzed is primary reasons that are behind the absence of staffs of the nursing in the health care sectors.


Belita, A., Mbindyo, P., & English, M. (2013). Absenteeism amongst health workers–developing a typology to support empiric work in low-income countries and characterizing reported associations. Human resources for health, 11(1), 34.

Daouk-?yry, L., Anouze, A. L., Otaki, F., Dumit, N. Y., & Osman, I. (2014). The JOINT model of nurse absenteeism and turnover: a systematic review. International journal of nursing studies, 51(1), 93-110.

Durand, M. J., Corbi?re, M., Coutu, M. F., Reinharz, D., & Albert, V. (2014). A review of best work-absence management and return-to-work practices for workers with musculoskeletal or common mental disorders. Work, 48(4), 579-589.

Engel, C. C., Bray, R. M., Jaycox, L. H., Freed, M. C., Zatzick, D., Lane, M. E., ... & Tanielian, T. (2014). Implementing collaborative primary care for depression and posttraumatic stress disorder: design and sample for a randomized trial in the US military health system. Contemporary clinical trials, 39(2), 310-319.

Fagan, P. S., Downing, S. G., McCall, B. J., Carroll, H. J., Howard, T. M., & Palmer, C. M. (2014). Enhanced surveillance for gonorrhoea in two diverse settings in Queensland in the 2000s: comparative epidemiology and selected management outcomes. Communicable Diseases Intelligence, 37(3).

Gosselin, E., Lemyre, L., & Corneil, W. (2013). Presenteeism and absenteeism: Differentiated understanding of related phenomena. Journal of occupational health psychology, 18(1), 75.

Johnson, M. D., Holley, E. C., Morgeson, F. P., LaBonar, D., & Stetzer, A. (2014). Outcomes of absence control initiatives: A quasi-experimental investigation into the effects of policy and perceptions. Journal of Management, 40(4), 1075-1097.

Jones, A., & Killion, S. (2017). title Clinical governance for Primary Health Networks.

Kangas, M., Muotka, J., Huhtala, M., M?kikangas, A., & Feldt, T. (2017). Is the ethical culture of the organization associated with sickness absence? A multilevel analysis in a public sector organization. Journal of Business Ethics, 140(1), 131-145.

Keasberry, J., Scott, I. A., Sullivan, C., Staib, A., & Ashby, R. (2017). Going digital: a narrative overview of the clinical and organisational impacts of eHealth technologies in hospital practice. Australian Health Review.

Kocakulah, M. C., Kelley, A. G., Mitchell, K. M., & Ruggieri, M. P. (2016). Absenteeism problems and costs: causes, effects and cures. The International Business & Economics Research Journal (Online), 15(3), 89.

Kristman, V. L., Shaw, W. S., Boot, C. R., Delclos, G. L., Sullivan, M. J., & Ehrhart, M. G. (2016). Researching complex and multi-level workplace factors affecting disability and prolonged sickness absence. Journal of occupational rehabilitation, 26(4), 399-416.


Nelson, A. E., Allen, K. D., Golightly, Y. M., Goode, A. P., & Jordan, J. M. (2014, June). A systematic review of recommendations and guidelines for the management of osteoarthritis: The Chronic Osteoarthritis Management Initiative of the US Bone and Joint Initiative. In Seminars in arthritis and rheumatism (Vol. 43, No. 6, pp. 701-712). WB Saunders.

Swink, M., Melnyk, S. A., Cooper, M. B., & Hartley, J. L. (2014). Managing operations across the supply chain (pp. 248-249). New York, NY: McGraw-Hill/Irwin.

Vossen, E., & van Gestel, N. (2015). The activation logic in national sickness absence policies: Comparing the Netherlands, Denmark and Ireland. European Journal of Industrial Relations, 21(2), 165-180.

Y?ld?z, H., Y?ld?z, B., Zehir, C., & Ayka?, M. (2015). The antecedents of presenteeism and sickness absenteeism: A research in Turkish health sector. Procedia-Social and Behavioral Sciences, 207, 398-403.

Zboril-Benson, L. R. (2016). Why nurses are calling in sick: the impact of health-care restructuring. Canadian Journal of Nursing Research Archive, 33(4).

Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., Clack, L., ... & Pittet, D. (2015). Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. The Lancet Infectious Diseases, 15(2), 212-224.

Zuo, J., & Zhao, Z. Y. (2014). Green building research–current status and future agenda: A review. Renewable and Sustainable Energy Reviews, 30, 271-281.

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