Sickness absence in doctors a comparison of recorded sickness absence with selfreported sickness abs

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Sickness absence in doctors a comparison of
recorded sickness absence with self-reported
sickness absence in a UK National Health Service
hospital

• Dr Ian Murphy
• Consultant Occupational Physician

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Presentation

• introduction
• objective
• methods
• results
• conclusions

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Sickness absence research

• studies in general show an inverse association
  between sickness absence measures and employment
  grade
• not many studies on health care workers
• most show that doctors have much lower recorded
  sickness absence measures than other health care
  occupational groups

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Reasons

• doctors may genuinely take less sick leave
• doctors may have sickness absence which is
  unreported and/or unrecorded
• combination of the above
• an assumption in the literature that higher
  employment grades under-report

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Study Objective

• to measure and compare recorded sickness absence
  with self-reported sickness absence in doctors
• the null hypothesis that there is no
  difference between recorded sickness absence and
  self-reported sickness absence in the group of
  doctors studied

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Methods

• a postal questionnaire that asked doctors about
  their sickness absence in the previous six months
• 1 March 2000 to 31 August 2000
• study population - all doctors employed by the
  hospital on 21 September 2000

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Setting

• Royal Berkshire and Battle Hospitals NHS Trust,
  Reading, Berkshire
• 780 beds
• 3,500 staff
• 371 doctors

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Recorded sickness absence

• absence policy
• self certificates and GPs certificates collated
  and recorded by salaries and wages on a
  computerised database
• 4 day absences and above recorded

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Ethics

• local research ethics committee
• medical director
• chairman of local negotiating committee
• director of human resources
• director of finance
• trust research and development committee

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Study population

• 371 doctors
• 311 whole time equivalents
• 12 grades from house officer to consultant
• 121 consultants (33)
• 103 non consultant career grades (28)
• 147 junior doctors in training (39)

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Comparison of self-reported data with recorded
data

• response rate 83.3 (304/371)
• questionnaire data
  payroll data
• any absence n () 60 (20) 11 (3)
• episodes (n) 69 11
• total duration (days) 445 127
• absence rate () 1.2 0.3

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Comparing like with like

• sickness absence of 4 days or more
  questionnaire data payroll data
• episodes (n) 19 9
• total duration (days) 369 125
• 21 matched pairs of episodes of self-reported and
  recorded sickness absence of four days or more

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Statistics

• matched pair t-test (assuming null hypothesis of
  no difference)
• mean for self-reported absence 17.6 days
• mean for recorded absence 6.0 days
• difference between means 11.6 days (95
  CI 1.7 to 21.7) ( p 0.023)

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Conclusion (1)

• study objective achieved
• recorded sickness absence for doctors lower than
  self-reported sickness absence
• the difference was statistically significant

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Conclusion (2)

• evidence that doctors have low self-reported
  sickness absence levels
• that there is an even lower recorded sickness
  absence level
• study indicates under reporting and/or under
  recording of sickness absence in doctors