UE - TDM - Teses de Doutoramento
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- On-Site vs. Off-Site practices of MSD intervention and its impact on Organizational - Productivity, Absenteeism and Costs.Theoretical analysis with applicationPublication . Hatch, Andrew Phillip; Tomé, EduardoPurpose: To establish to what degree musculoskeletal disorders (MSDs) impacted employee productivity, and to compare the impact of an On-Site, verses an Off-Site care strategy in the context of MSD related productivity losses, absenteeism and the associated costs. Theoretical Foundation: MSDs have been shown to be the single greatest cause of long, short and permanent work disability globally and a primary driver of direct and indirect costs. Presenteeism, has been shown to cost organization more in productivity losses than absenteeism or direct medical costs. Methods: Two studies were performed to evaluate similar, seated computer-based employees from three large corporations. Productivity study, done in two phases to measure the impact that MSDs have on employee productivity and to measure the impact of the On-Site MSD treatment. The instrument used was; the WLQ or Work Limitations Questionnaire. The Absenteeism study measured and compared absenteeism rates between employees who used the On-Site clinics in the past year, with employees with MSDs who chose Off-site options. An Absenteeism Questionnaire was used to measure MSD related absenteeism in the context of disability days, treatments, medical consults and diagnostics. An average wage method was used to calculate the average cost per-year, per-case (employee). Findings: Phase 1: WLQ average Lost Productivity Score of 10.5% which translated into an average total lost productivity cost of €1,478.25 per year. The Phase 2 follow up revealed the study group WLQ score dropped from 10.5% to 1.86% at a saving of €1,197.71 per person per year. The Control group average WLQ score was 11.2% and rose to 12.06%, or an additional loss of €118.13 per person per year. Absenteeism study; Total average absenteeism in working hours per-person, per-year, On-Site vs. Off-Site were, 16.62 hours and 68.38 hours respectively costing €108.07 and €444.72 respectively. The average time an employee needed to wait, from the time of onset of symptom, to the time of first treatment, was 3.6 days (28.8 working hours) for On-Site and 14.09 days (119.2 working hours) for Off-Site respectively. Conclusion: MSDs contributed greatly to costly employee productivity losses and presenteeism, and an On-Site treatment strategy significantly reduced productivity losses. The On-Site intervention demonstrated significantly lower absenteeism rates and lower disability rates, required fewer treatments, external consults and external diagnostics and less waiting time than employees seeking Off-Site care. Originality: Measuring the comparative economic impact on organizations between On-Site and Off-Site treatment strategies for MSDs. This study measured productivity losses as presenteeism, and absenteeism, in terms of days and hours lost for medical treatments and exams as well as the impact of a presenteeism lowering strategies for MSDs. Limitations: On-Site MSD clinics are rare. The sample did not represent the general Portuguese population. The average wage formula did not allow for actual costs. Study was not blinded. Practical and Research Implications: The On-Site model can be used with larger samples representing a wider spectrum of the population which could potentially lead to a cost-effective strategy for the government (SNS), and a decreased burden on the health care systems.