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ABSTRACT: In Australia a persistent and sizable gender wage gap exists. In recent years this gap has been steadily widening. The negative impact of gender wage differentials is the disincentive to work more hours. This implies a substantial cost on the Australian health sector. This study aimed to identify the magnitude of gender wage differentials within the health sector. The investigation accounts for unpaid overtime. Given the limited availability of information, little empirical evidence exists that accounts for unpaid overtime.
Information was collected from a sample of 10,066 Australian full-time employees within the health sector. Initially, ordinary least-squares regression was used to identify the gender wage gap when unpaid overtime was included and then excluded from the model. The sample was also stratified by gender and then by occupation to allow for comparisons. Later the Blinder-Oaxaca decomposition method was employed to identify and quantify the contribution of individual endowments to wage differentials between males and females.
The analyses of data revealed a gender wage gap that varied across occupations. The inclusion of unpaid overtime in the analysis led to a slight reduction in the wage differential. The results showed an adjusted wage gap of 16.7%.
Unpaid overtime made a significant but small contribution to wage differentials. Being female remained the major contributing factor to the wage gap. Given that wage differentials provide a disincentive to work more hours, serious attempts to deal with the skilled labour shortage in the health sector need to address the gender wage gap.
Human Resources for Health 01/2013; 11(1):9. · 1.83 Impact Factor
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ABSTRACT: The health condition of workers is known to impact on productivity outcomes. The relationship between health and productivity is of increasing interest amid the need to increase productivity to meet global financial challenges. Prevalence of psychological distress is also of growing concern in Australia with a two-fold increase in the prevalence of psychological distress in Australia from 1997-2005.
We used the cross-sectional data set from the Australian Work Outcomes Research Cost-benefit (WORC) study to explore the impacts of health conditions with and without co-morbid psychological distress, compared to those with neither condition, in a sample of approximately 78,000 working Australians. The World Health Organisation Health and Performance Questionnaire was used which provided data on demographic characteristics, health condition and working conditions. Data were analysed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism respectively.
For both absenteeism and presenteeism productivity measures there was a greater risk of productivity loss associated when health conditions were co-morbid with psychological distress. For some conditions this risk was much greater for those with co-morbid psychological distress compared to those without.
Co-morbid psychological distress demonstrates an increased risk of productivity loss for a range of health conditions. These findings highlight the need for further research to determine whether co-morbid psychological distress potentially exacerbates lost productivity.
BMC Public Health 05/2011; 11:417. · 2.00 Impact Factor
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ABSTRACT: To identify health conditions associated with productivity loss in working Australians, adjusting for comorbidity, demographics, and work-related characteristics.
The Australian Work Outcomes Research Cost-benefit study cross-sectional screening data set was used to identify health-related productivity losses in a sample of approximately 78,000 working Australians. Data collected with the World Health Organisation Health and Productivity Questionnaire were analyzed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism, respectively.
Health conditions impacted on both presenteeism and absenteeism. Drug and alcohol problems and psychological distress had a greater impact on absenteeism and presenteeism than other investigated health conditions. Demographic characteristics, health status (comorbidity), and work-related characteristics all impacted significantly on both absenteeism and presenteeism.
Mental health conditions contributed more strongly to productivity loss than other investigated health conditions.
Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 02/2011; 53(3):253-7. · 1.88 Impact Factor
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ABSTRACT: Multimorbidity is becoming more prevalent. Previously-used methods of assessing multimorbidity relied on counting the number of health conditions, often in relation to an index condition (comorbidity), or grouping conditions based on body or organ systems. Recent refinements in statistical approaches have resulted in improved methods to capture patterns of multimorbidity, allowing for the identification of nonrandomly occurring clusters of multimorbid health conditions. This paper aims to identify nonrandom clusters of multimorbidity.
The Australian Work Outcomes Research Cost-benefit (WORC) study cross-sectional screening dataset (approximately 78,000 working Australians) was used to explore patterns of multimorbidity. Exploratory factor analysis was used to identify nonrandomly occurring clusters of multimorbid health conditions.
Six clinically-meaningful groups of multimorbid health conditions were identified. These were: factor 1: arthritis, osteoporosis, other chronic pain, bladder problems, and irritable bowel; factor 2: asthma, chronic obstructive pulmonary disease, and allergies; factor 3: back/neck pain, migraine, other chronic pain, and arthritis; factor 4: high blood pressure, high cholesterol, obesity, diabetes, and fatigue; factor 5: cardiovascular disease, diabetes, fatigue, high blood pressure, high cholesterol, and arthritis; and factor 6: irritable bowel, ulcer, heartburn, and other chronic pain. These clusters do not fall neatly into organ or body systems, and some conditions appear in more than one cluster.
Considerably more research is needed with large population-based datasets and a comprehensive set of reliable health diagnoses to better understand the complex nature and composition of multimorbid health conditions.
Population Health Metrics 01/2011; 9(1):15. · 2.11 Impact Factor
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ABSTRACT: This paper is a report of a correlational study of the relationships between work-related injury-risk events and modifiable risk factors in a nursing population after controlling for socioeconomic factors.
Nurses are at high risk for work-related injury. Work-related injury is strongly influenced by psychosocial factors and physical job-related exposures, but the magnitude of effect from modifiable factors remains unclear.
Data were based on the Work Outcomes Research Cost-benefit survey conducted in Australia during 2005 and 2006. The study sample of 5724 represented ~14% of nurses in Queensland, Australia. Logistic regression was used to determine the magnitude of association of psychological distress (represented by the Kessler 6 score: six-item scale of psychological distress), the number of health conditions and various socioeconomic factors with work place injury.
High psychological distress was associated with a 5% probability of injury. As the number of health conditions increased, the probability of injury increased; 3 and ≥ 6 health conditions increased the chance of injury by 5% and 15% compared with no health conditions. Compared with the total sample, nurses who reported high levels of psychological distress demonstrated greater sensitivity to the number of health conditions. Computation of the marginal effects showed little difference in the likelihood of injury when the total sample was compared with nurses with < 5 years of work experience.
Effective occupational health and safety workplace programmes that target modifiable factors such as psychological distress and physical health conditions may improve the health capital of nurses and productivity levels within the profession.
Journal of Advanced Nursing 01/2011; 67(5):1067-78. · 1.48 Impact Factor
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ABSTRACT: This study investigates associations between psychological distress and workplace accidents, workplace failures and workplace successes.
The Health and Work Performance Questionnaire (HPQ) was distributed to employees of 58 large employers. A total of 60,556 full-time employees were eligible for analysis. The HPQ probed whether the respondent had, in the past 30-days, a workplace accident, success or failure ("yes" or "no"). Psychological distress was quantified using the Kessler 6 (K6) scale and categorised into low, moderate and high psychological distress. Three binomial logistic regressions were performed with the dependent variables being workplace accident, success or failure. Covariates in the models were K6 category, gender, age, marital status, education level, job category, physical health and employment sector.
Accounting for all other variables, moderate and high psychological distress significantly (P < 0.0001) increased the odds ratio (OR) for a workplace accident to 1.4 for both levels of distress. Moderate and high psychological distress significantly (P < 0.0001) increased the OR (OR = 2.3 and 2.6, respectively) for a workplace failure and significantly (P < 0.0001) decreased the OR for a workplace success (OR = 0.8 and 0.7, respectively).
Moderate and high psychological distress increase the OR's for workplace accidents work failures and decrease the OR of workplace successes at similar levels. As the prevalence of moderate psychological distress is approximately double that of high psychological distress moderate distress consequentially has a greater workplace impact.
Archiv für Gewerbepathologie und Gewerbehygiene 12/2010; 83(8):923-33. · 1.89 Impact Factor
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ABSTRACT: Although there is population data on the prevalence and treated prevalence of mental disorders by urban-rural indices, there is a lacuna of information pertaining to employees. This paper examines the prevalence and treated prevalence of psychological distress in employees by urban-rural indicators.
Cross-sectional employee Health and Performance at Work Questionnaire responses (n=78,726 from 58 large companies) are interrogated by indices of remoteness (Accessibility/Remoteness Index of Australia), psychological distress (Kessler 6) and treatment-seeking behaviours for mental health problems.
The overall prevalence of moderate or high psychological distress in employees was 35.2%. The prevalence varied only slightly (maximum to minimum difference of 4.6%) by rural/remote indices. Overall treatment-seeking behaviour for psychological distress was low (22.5%). The percentage of employees seeking treatment for high levels of psychological distress was the lowest in very remote regions (15.1%). Conclusion: Very remote employees are less likely to access mental health treatments and may be an employee subgroup that would benefit from specific employer health interventions aimed to increase treatment-seeking behaviours.
Employees in very remote Australia could benefit from specific interventions aimed to increase mental health awareness/literacy.
Australian and New Zealand Journal of Public Health 10/2010; 34(5):458-65. · 1.20 Impact Factor
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ABSTRACT: To demonstrate the importance of including a range of working conditions in models exploring the association between health- and work-related performance.
The Australian Work Outcomes Research Cost-benefit study cross-sectional screening data set was used to explore health-related absenteeism and work performance losses on a sample of approximately 78,000 working Australians, including available demographic and working condition factors. Data collected using the World Health Organization Health and Productivity Questionnaire were analyzed with negative binomial logistic regression and multinomial logistic regressions for absenteeism and work performance, respectively.
Hours expected to work, annual wage, and job insecurity play a vital role in the association between health- and work-related performance for both work attendance and self-reported work performance.
Australian working conditions are contributing to both absenteeism and low work performance, regardless of health status.
Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 02/2010; 52(3):281-90. · 1.88 Impact Factor
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ABSTRACT: In Australia it has been estimated that mental health symptoms result in a loss of $ AU2.7 billion in employee productivity. To date, however, there has been only one study quantifying employee productivity decrements due to mental disorders when treatment-seeking behaviours are considered. The aim of the current paper was to estimate employee work productivity by mental health symptoms while considering different treatment-seeking behaviours.
A total of 60 556 full-time employees responded to the World Health Organization Health and Work Performance Questionnaire. This questionnaire is designed to monitor the work productivity of employees for chronic and acute physical and mental health conditions. Contained within the questionnaire is the Kessler 6, a scale measuring psychological distress along with an evaluation of employee treatment-seeking behaviours for depression, anxiety and any other emotional problems. A univariate analysis of variance was performed for employee productivity using the interaction between Kessler 6 severity categories and treatment-seeking behaviours.
A total of 9.6% of employees have moderate psychological distress and a further 4.5% have high psychological distress. Increasing psychological distress from low to moderate then to high levels is associated with increasing productivity decrements (6.4%, 9.4% and 20.9% decrements, respectively) for employees in current treatment. Combining the prevalence of Kessler 6 categories with treatment-seeking behaviours, mean 2009 salaries and number of Australian employees in 2009, it is estimated that psychological distress produces an $ AU5.9 billion reduction in Australian employee productivity per annum.
The estimated loss of $ AU5.9 billion in employee productivity due to mental health problems is substantially higher than previous estimates. This finding is especially pertinent given the global economic crisis, when psychological distress among employees is likely to be increasing. Effective treatment for mental health problems yields substantial increases in employee productivity and would be a sound economic investment for employers.
Australian and New Zealand Journal of Psychiatry 02/2010; 44(2):151-61. · 2.93 Impact Factor
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ABSTRACT: The 1-month prevalence of any mental disorder in employees ranges from 10.5% to 18.5%. Mental disorders are responsible for substantial losses in employee productivity in both absenteeism and presenteeism. Potential work related factors contributing to mental difficulties are of increasing interest to employers. Some data suggests that being sales staff, call centre operator, nurse or teacher increases psychological distress. One aspect of these occupations is that there is an interaction with the public. The aim of this study is to evaluate whether employees who interact with the public are at greater risk of psychological distress.
Data was collected from two studies. In study one 11,259 employees (60% female; mean age 40-years +/- SD 10-years) from six employers responded to the Health and Work Performance Questionnaire (HPQ) which contained a measure of psychological distress, the Kessler 6 (K6). Employees were coded as to whether or not they interacted with the public. Binomial logistic regression was performed on this data to determine the odds ratio (OR) for moderate or high psychological distress in employees that interacted with the public. Study two administered the HPQ and K6 to sales employees of a large Australian bank (N = 2,129; 67% female; mean age 39-years SD 10-years). This questionnaire also probed how many contacts individuals had with the public in the past week. Analysis of variance was used to determine if the number of contacts was related to psychological distress.
In study one the prevalence of psychological distress in those that interacted and did not interact with the public were 19% and 15% respectively (P < 0.001). Interacting with the public was associated with an increased OR of 1.3 (P < 0.001) for moderate to high levels of psychological distress. In study two employees with less than 25 contacts with the public per week had a lower K6 score than those who had > or = 25 contacts per week (P = 0.016).
The results of the current study are indicative that interaction with the public increases levels of psychological distress. Employees dealing with the public may be an employee subgroup that could be targeted by employers with mental health interventions.
BMC Public Health 01/2010; 10:435. · 2.00 Impact Factor
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ABSTRACT: In a large cross-sectional study, this article investigates associations between employee work productivity, psychological distress, and the treatment of mental disorders.
Sixty thousand five hundred fifty-six Australian employees completed the Health and Work Performance Questionnaire (HPQ). The HPQ quantified treatment seeking behavior for depression, anxiety, or other mental disorders. The HPQ also evaluated the level of psychological distress (Kessler 6 [K6]) and employee productivity measures.
The productivity of employees without psychological distress and who have not been in treatment of a mental disorder was 20% (SE = 0.3%). The productivity of a successfully treated employee (low K6) for a mental disorder was 17% (SE = 0.6%).
Treatment of mental disorders resulting in normalization of symptoms is associated with employees' productivity returning to values approaching those of employees without a history of a mental disorder.
Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 10/2009; 51(9):996-1003. · 1.88 Impact Factor
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ABSTRACT: High levels of psychological distress in fulltime employees are prevalent (4.5% per month). Symptoms of impaired mental health include difficulties with attention, concentration, motivation, decision-making, visuo-motor control, and psychomotor reaction times. There is limited research on the impact these symptoms have on heavy goods vehicle (HGV) drivers' performance. In this study 1324 HGV drivers were surveyed using the Depression, Anxiety, Stress Scale (DASS) and the Health and Performance at Work Questionnaire (HPQ). Depression, anxiety and stress had little effect on driver absenteeism rates or self-rated driving performance. However, severe (1.5% of drivers) and very severe (1.8% of drivers) depression was associated with an increased odds ratio (OR=4.5 and 5.0, respectively) for being involved in an accident or near miss in the past 28 days. This odd ratio is akin to driving with a blood alcohol content of about 0.08%. Given the number of HGV vehicles and the prevalence of depression this equates to 10,950 HGV drivers with an increased statistical risk of an accident or near miss. As the impact of HGV accidents is potentially large, including loss of life, it would be sensible to extend the research findings here into an action plan.
Accident; analysis and prevention 06/2009; 41(3):453-61. · 1.65 Impact Factor
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ABSTRACT: Absenteeism rates are the cornerstone metrics guiding corporate policy for health care investment in employees. However, traditional absenteeism measures do not reflect the contemporary workplace milieu. It is accepted practice that employees work evenings or weekends to makeup time. Using a hours-based absenteeism measure, that accounts for time made-up as well as time lost, this paper evaluates the impact of psychological distress on employee absenteeism.Psychological distress and absenteeism data were collected from 54,264 full-time employees. Consistent with traditional approaches, employees indicated how many days they were absent. Hours based absenteeism was formulated from the ratio of how many hours the employees worked and how many hours were they expected to work in the past seven-days.Concordant with previous concinnous evidence, traditional absenteeism computation indicated that elevated psychological distress is associated with increasing absenteeism. Using the hours-based method psychological distress did not significantly influence absenteeism.Traditional calculations of absenteeism do not reflect the current work practices of the majority of employees. Employees with psychological distress may take time off work but it appears that they make up for lost time possibly to stay up to speed with task driven occupations and avoid performance review.
International Journal of Methods in Psychiatric Research 02/2009; 18(1):37-47. · 2.46 Impact Factor
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ABSTRACT: Pro re nata (PRN; 'as needed') medication is an archetypal mainstay for managing acute psychiatric inpatient symptoms and behaviours. Psychiatric and mental health nursing practices have circumnavigated the development of a uniform medical-ethical standard for the administration of PRN psychotropic medication. This paper examines the evidence for administration of PRN psychotropic medications and, in the context of evidence-based best practice, current mental health policy and professional ethics, proposes a standardized Australian PRN administration protocol. The procedures and circumstances leading to a nurse administering psychotropic PRN medication are divided into five simple steps, namely (i) medical prescription; (ii) nurse evaluation of patient indications for an intervention; (iii) nurse consideration of therapeutic options; (iv) obtaining patient informed consent; and (v) documentation of outcomes of PRN administration. The literature associated with each step is reviewed, along with national and international professional ethics, guidelines and patient rights documents pertaining to the care of mental health patients. Recommendations for best-practise care are discussed for each step. There is a lacuna of published evidence supporting the use of PRN medications in psychiatric inpatients. Yet there is published evidence that PRN medications are associated with increased risks of morbidity, inappropriate use, may result in above-recommended dosages or polypharmacy, and complicate the assessment of efficacy of regular scheduled medicines. Alternative non-pharmacological treatment options to PRN medication are effective and associated with fewer side-effects. There are no national explicit standards, operational criteria or quality assurance for the use of PRN medication in inpatient psychiatric units. Contemporary PRN practices are largely unregulated and driven by essentially anecdotal evidence, leaving the clinicians and the service open to claims of poor accountability and misuse (intentional and unintentional) of psychotropic medications. Development of best practice guidelines for the use of PRN administration is essential.
Australian and New Zealand Journal of Psychiatry 08/2008; 42(7):555-64. · 2.93 Impact Factor
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ABSTRACT: Objectives: To demonstrate the importance of including a range of working conditions in models exploring the association between health- and workrelated performance. Methods: The Australian Work Outcomes Research Cost-benefit study cross-sectional screening data set was used to explore health-related absenteeism and work performance losses on a sample of approximately 78,000 working Australians, including available demographic and working condition factors. Data collected using the World Health Organization Health and Productivity Questionnaire were analyzed with negative binomial logistic regression and multinomial logistic regressions for absenteeism and work performance, respectively. Results: Hours expected to work, annual wage, and job insecurity play a vital role in the association between health- and work-related performance for both work attendance and self-reported work performance. Conclusions: Australian working conditions are contributing to both absenteeism and low work performance, regardless of health status. Yes Yes
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ABSTRACT: Objectives: In a large cross-sectional study, this article investigates associations between employee work productivity, psychological distress, and the treatment of mental disorders. Methods: Sixty thousand five hundred fifty-six Australian employees completed the Health and Work Performance Questionnaire (HPQ). The HPQ quantified treatment seeking behavior for depression, anxiety, or other mental disorders. The HPQ also evaluated the level of psychological distress (Kessler 6 [K6]) and employee productivity measures. Results: The productivity of employees without psychological distress and who have not been in treatment of a mental disorder was 20% (SE = 0.3%). The productivity of a successfully treated employee (low K6) for a mental disorder was 17% (SE = 0.6%). Conclusions: Treatment of mental disorders resulting in normalization of symptoms is associated with employees' productivity returning to values approaching those of employees without a history of a mental disorder. Yes Yes
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ABSTRACT: Objective: In Australia it has been estimated that mental health symptoms result in a loss of $ AU2.7 billion in employee productivity. To date, however, there has been only one study quantifying employee productivity decrements due to mental disorders when treatmentseeking behaviours are considered. The aim of the current paper was to estimate employee work productivity by mental health symptoms while considering different treatment-seeking behaviours. Method: A total of 60 556 full-time employees responded to the World Health Organization Health and Work Performance Questionnaire. This questionnaire is designed to monitor the work productivity of employees for chronic and acute physical and mental health conditions. Contained within the questionnaire is the Kessler 6, a scale measuring psychological distress along with an evaluation of employee treatment-seeking behaviours for depression, anxiety and any other emotional problems. A univariate analysis of variance was performed for employee productivity using the interaction between Kessler 6 severity categories and treatment-seeking behaviours. Results: A total of 9.6% of employees have moderate psychological distress and a further 4.5% have high psychological distress. Increasing psychological distress from low to moderate then to high levels is associated with increasing productivity decrements (6.4%, 9.4% and 20.9% decrements, respectively) for employees in current treatment. Combining the prevalence of Kessler 6 categories with treatment-seeking behaviours, mean 2009 salaries and number of Australian employees in 2009, it is estimated that psychological distress produces an $ AU5.9 billion reduction in Australian employee productivity per annum. Conclusions: The estimated loss of $ AU5.9 billion in employee productivity due to mental health problems is substantially higher than previous estimates. This fi nding is especially pertinent given the global economic crisis, when psychological distress among employees is likely to be increasing. Effective treatment for mental health problems yields substantial increases in employee productivity and would be a sound economic investment for employers. Key words: efficiency, employees, industrial, mental health, occupational health, psychology. Yes Yes
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ABSTRACT: Accounting for the endogenous relationship between health and hours worked, the goal of this study was to estimate the effect of mental health on the working hours of nursing professionals. The impact of hours worked on mental health was also investigated. The data was based on the Work Outcomes Research Cost-benefit (WORC) survey conducted in Australia during 2005 and 2006. The study sample of 6086 nurses represented ~15 per cent of nurses in Queensland. Analysis involved the use of simultaneous equations estimated with Generalized Method of Moments. The analysis of the data identified an endogenous relationship between mental health and hours of labour supplied. The findings revealed that among Queensland nurses, a deterioration of mental health was associated with a reduction in hours worked and increasing hours worsened mental health. The findings imply that an effective approach to meeting nursing shortages should include strategic attempts to improve the mental health capital of nursing staff. Previous studies have shown resilience training in the workplace as effective in increasing the supply of labor. Yes Yes
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ABSTRACT: Objective: Mental ill-health results in substantial reductions in employee productivity (absenteeism and presenteeism). This paper examines the relationship between employee psychological distress, employee type and productivity. Method: Utilizing the Health and Performance at Work Questionnaire, in a sample of 60,556 full-time employees, the impact that psychological distress (Kessler 6) imposes on employee productivity by occupation type is examined. Results: Comparison of white-collar workers absenteeism rates by low and high psychological distress reveals no statistically significant difference. Nevertheless, the same comparison for blue-collar workers reveals that high psychological distress results in an 18% increase in absenteeism rates. High K6 score resulted in a presenteeism increase of 6% in both blue and white-collar employees. Conclusion: The novel finding is that mental ill-health produces little to no absenteeism in white-collar workers yet a profound absenteeism increase in the blue-collar sector. Yes Yes
