The effect of hospital mergers on long-term sickness absence among hospital employees: a fixed effects multivariate regression analysis using panel data

Abstract

BackgroundHospitals are merging to become more cost-effective. Mergers are often complex and difficult processes with variable outcomes. The aim of this study was to analyze the effect of mergers on long-term sickness absence among hospital employees.MethodsLong-term sickness absence was analyzed among hospital employees (N = 107 209) in 57 hospitals involved in 23 mergers in Norway between 2000 and 2009. Variation in long-term sickness absence was explained through a fixed effects multivariate regression analysis using panel data with years-since-merger as the independent variable.ResultsWe found a significant but modest effect of mergers on long-term sickness absence in the year of the merger, and in years 2, 3 and 4; analyzed by gender there was a significant effect for women, also for these years, but only in year 4 for men. However, men are less represented among the hospital workforce; this could explain the lack of significance.ConclusionsMergers has a significant effect on employee health that should be taken into consideration when deciding to merge hospitals. This study illustrates the importance of analyzing the effects of mergers over several years and the need for more detailed analyses of merger processes and of the changes that may occur as a result of such mergers.

Hospital Mergers in Norway: Employee Health and Turnover to Three Destinations

“…Studying the same hospital mergers as those analyzed in this article, Kjekshus et al (2014) found that sickness absence among staff who remained employed at the same hospital was significantly higher in the merger year and in the second to fourth year after the merger than in nonmerger years. Josephson et al (2008) argue that turnover and sickness absence are two separate ways of actively coping with unhealthy working conditions.…”

“…Employee participation is generally believed to facilitate restructuring at the company level (Løken et al, 2013). When studying the effects of hospital mergers in Norway on the employees, it is important to keep in mind that the hospital mergers in Norway have not entailed major downsizing (Kjekshus et al, 2014).…”

“…Mergers are associated with increases in general anxiety disorders (Wang et al, 2012), exhaustion, functional incapacity (Vaananen et al, 2004), and psychiatric events (Vaananen et al, 2011). Earlier research on hospital staff has shown that mergers are associated with emotional costs due to anxiety, uncertainty, higher workloads (Fulop et al, 2005), and increased sickness absence (Kjekshus et al, 2014).…”

“…Mergers are likely to be followed by internal organizational changes in the merged organization (Kjekshus et al, 2014). Effects of other types of organizational change suggest that they are associated with a deterioration of psychosocial working conditions (Bourbonnais et al, 2005;Robinson and Griffiths, 2005) and increased sickness absence (Bernstrom and Kjekshus, 2015;Kokkinen et al, 2013;Røed and Fevang, 2007).…”

“…While hospital mergers are increasingly initiated to save costs and to achieve higher efficiency and better quality care (Kjekshus and Hagen, 2007), reviewers of research on mergers and acquisitions call for more studies on their effect on employees (Haleblian et al, 2009: 488). A large body of research has documented negative health effects of mergers on employees (Fulop et al, 2005;Kjekshus et al, 2014;Vaananen et al, 2011;Vaananen et al, 2004;Wang et al, 2012). Moreover, previous research from the US has found that turnover increases during hospital mergers (Jick, 1979) and organizational change (Sylling et al, 2014).…”