Integrating quantitative and qualitative approaches to assess wintertime illness-related absenteeism and its direct and indirect costs among the private sector in Ulaanbaatar

Abstract

Causes for employee absenteeism vary. The commonest cause of work absenteeism is “illness-related.” Mongolia’s capital city, Ulaanbaatar, experiences high employee absenteeism during the winter than during other seasons due to the combination of extreme cold and extreme air pollution. We identified direct and indirect costs of absenteeism attributed to air pollution among private-sector employees in Ulaanbaatar. Using a purposive sampling design, we obtained questionnaire data for 1,330 employees working for private-sector companies spanning six economic sectors. We conducted 26 employee focus groups and 20 individual employer in-depth interviews. We used both quantitative and qualitative instruments to characterize the direct and indirect costs of absence due to illnesses attributed to severe air pollution during wintertime. Female employees and employees with a young child at home were more likely to be absent. Respiratory diseases accounted for the majority of reported air pollution-related illnesses. All participants perceived that air pollution adversely affected their health. Individual employee direct costs related to absence totaled 875,000 MNT ($307.10) for an average of three instances of three-day illness-related absences during the winter. This sum included diagnostic and doctor visit-related, medication costs and hospitalization costs. Non-healthcare-related direct cost (transportation) per absence was 50,000₮ ($17.60). Individual indirect costs included the value of lost wages for the typical 3-day absence, amounting to 120,000₮ ($42.10). These total costs to employees, therefore, may amount to as much as 10% of annual income. The majority of sick absences were unpaid. Overall, the cost of wintertime absences is substantial and fell disproportionately on female employees with young children.

Sickness absence among employees of healthcare organizations in the public sector in Mongolia: A cross-sectional study

“…A previous study including employees who worked for the private sector in Ulaanbaatar reported that respiratory disease was the major cause of SA, especially during winter, but that most SA was uncertified. 9 Factors associated with taking a long-term absence among HCWs who had SA were the age group ≥40 years old, 10-19 years in employment compared with 9 years or less, working at the secondary and tertiary levels compared with the primary level, and having night shifts. Older age and longer experience were associated with having a longterm SA.…”

“…A previous study including employees who worked for the private sector in Ulaanbaatar reported that respiratory disease was the major cause of SA, especially during winter, but that most SA was uncertified. 9 …”

“…Mongolian HCWs might have uncertified SA or work when they had minor respiratory diseases such as acute respiratory illness or influenza‐like illness. A previous study including employees who worked for the private sector in Ulaanbaatar reported that respiratory disease was the major cause of SA, especially during winter, but that most SA was uncertified 9 …”

“…There has been only one study on sickness absenteeism in Mongolia, which included 1330 employees in private companies. 9 The study focused on absences due to illness of the employees or their families related to air pollution in winter and factors associated with wintertime absences were females, having a child, and more years in employment. It was also suggested that the total cost due to wintertime absences might be fairly large.…”

“…Mongolia is a lower middle‐income country located in East Asia with a population of 3.41 million. There has been only one study on sickness absenteeism in Mongolia, which included 1330 employees in private companies 9 . The study focused on absences due to illness of the employees or their families related to air pollution in winter and factors associated with wintertime absences were females, having a child, and more years in employment.…”