Evaluating quick return restrictions on sickness absence in healthcare employees: A difference-in-differences study

Area of Science:

• Occupational Health
• Public Health Policy
• Healthcare Management

Background:

• Short intervals between shifts (quick returns) are linked to adverse health effects and increased occupational accidents in healthcare.
• Finland's 2020 Working Time Act reform aimed to limit rest periods under 11 hours for irregular shift work to protect employee health.

Purpose of the Study:

• To evaluate the impact of the 2020 Working Time Act reform on quick returns in Finnish public healthcare.
• To assess the association between reduced quick returns and sickness absence among healthcare employees.

Main Methods:

• Quasi-experimental, difference-in-differences regression analysis of sickness absence data from 2019-2021.
• Comparison of hospital units mandated to limit quick returns (treatment group) versus those with low pre-reform quick returns (control group).
• Intention-to-treat and per-protocol analyses, with sensitivity analyses using covariates and inverse probability weighting.

Main Results:

• The reform was associated with a significant reduction in the increase of sickness absence.
• Per-protocol analysis showed a 13% lower sickness absence rate in the treatment group for 2019-2020.
• Adjusted analyses indicated a more substantial reduction in sickness absence, with estimates ranging from -0.6 to -0.9 percentage points.

Conclusions:

• The Working Time Act reform effectively reduced quick returns.
• Reduced quick returns were linked to a smaller increase in sickness absence among healthcare workers.
• Policymakers and managers should consider adjusting quick return frequencies to enhance employee well-being and operational efficiency.