PDF(Pubmed)
Abstract：
BACKGROUND: This study explores the impact of decentralized management on the sickness absence among healthcare professionals. Sickness absence is a reliable indicator of employees\' wellbeing and it is linked to management quality. However, the influence of decentralized management on sickness absence has not been adequately studied.
METHODS: The research design combined a two-wave, web-survey of frontline managers in two Danish university hospitals with administrative data on sickness absence at the ward-level. The first and second wave included data from 163165 and 137 frontline managers linked to 121 wards and 108 wards. Data was analysed using an ordinal logistic regression model.
RESULTS: Wards where frontline managers had the highest level of decentralised decision authority compared to none showed lower odds of ward-level sickness absence (ORcrude: 0.20, 95% CI: 0.05-0.87). A very high extent of cross-functional decision authority showed lower odds of sickness absence (ORcrude: 0.08, 95% CI: 0.01-0.49). Overall, the results showed a clear data trend, although not all results were statistically significant.
CONCLUSIONS: Higher levels of decentralized management in wards were positively associated with lower risks of sickness absence in hospital wards. The study supports future research on how to empower decision autonomy at the frontline level of management.
METHODS: The research design combined a two-wave, web-survey of frontline managers in two Danish university hospitals with administrative data on sickness absence at the ward-level. The first and second wave included data from 163165 and 137 frontline managers linked to 121 wards and 108 wards. Data was analysed using an ordinal logistic regression model.
RESULTS: Wards where frontline managers had the highest level of decentralised decision authority compared to none showed lower odds of ward-level sickness absence (ORcrude: 0.20, 95% CI: 0.05-0.87). A very high extent of cross-functional decision authority showed lower odds of sickness absence (ORcrude: 0.08, 95% CI: 0.01-0.49). Overall, the results showed a clear data trend, although not all results were statistically significant.
CONCLUSIONS: Higher levels of decentralized management in wards were positively associated with lower risks of sickness absence in hospital wards. The study supports future research on how to empower decision autonomy at the frontline level of management.
摘要：
背景：本研究探讨了分散管理对医疗保健专业人员缺勤的影响。病假是员工健康的可靠指标，它与管理质量有关。然而,分散管理对疾病缺勤的影响尚未得到充分研究。
方法：研究设计结合了两波，对两家丹麦大学医院的一线管理人员进行网络调查，并提供了病房一级疾病缺勤的行政数据。第一波和第二波包括来自与121个病房和108个病房相关的163165和137个前线经理的数据。使用序数逻辑回归模型分析数据。
结果：前线经理拥有最高分权决策权的病房与没有分权决策权的病房相比，其病区缺病率较低（ORcrude：0.20，95％CI：0.05-0.87）。非常高的跨职能决策机构显示出较低的缺病几率（ORcrude：0.08，95％CI：0.01-0.49）。总的来说,结果显示了明显的数据趋势，尽管并非所有结果都具有统计学意义。
结论：病房中更高水平的分散管理与医院病房中更低的疾病缺勤风险呈正相关。该研究支持未来关于如何在管理一线赋予决策自主权的研究。
方法：研究设计结合了两波，对两家丹麦大学医院的一线管理人员进行网络调查，并提供了病房一级疾病缺勤的行政数据。第一波和第二波包括来自与121个病房和108个病房相关的163165和137个前线经理的数据。使用序数逻辑回归模型分析数据。
结果：前线经理拥有最高分权决策权的病房与没有分权决策权的病房相比，其病区缺病率较低（ORcrude：0.20，95％CI：0.05-0.87）。非常高的跨职能决策机构显示出较低的缺病几率（ORcrude：0.08，95％CI：0.01-0.49）。总的来说,结果显示了明显的数据趋势，尽管并非所有结果都具有统计学意义。
结论：病房中更高水平的分散管理与医院病房中更低的疾病缺勤风险呈正相关。该研究支持未来关于如何在管理一线赋予决策自主权的研究。
