title: The validity of preemployment medical evaluations.
abstract: A protocol is described to determine whether a medical preemployment evaluation can be predictive for attendance or work performance. In addition, the dollar benefit and the cost of such a program is assessed. The present analysis is based on 4,936 men and women, who were processed as prospective hires into non-hazardous job assignments. A medical preemployment evaluation was performed on all applicants, identifying factors which could influence attendance or work performance. Sixty-nine per cent of the examined applicants were hired. During the employment process, all applicants were randomly assigned to a control or trial group. Those in the trial group were hired by the employment office without knowledge of the results of the medical preemployment evaluation, whereas these results were fully disclosed for applicants in the control group. Three months after hire, supervisors answered a detailed questionnaire relating to absence and work performance for each hire. No differences were identified between control and trial groups for overall job performance, appropriateness of the job match and work force losses. A small but significant difference, on the other hand, was identified for sickness absence in the trial group between medical evaluation category A (normal risk) and category R (increased risk identified). Omission of a preemployment medical evaluation, as simulated by the trial group, increased the absence cost for the company by $2.30 per year for each new hire. Compared to a $17.50 cost per preemployment health evaluation, the average length of service of new hires would have to exceed 7.6 years to realize a dollar benefit from the medical examination. Examinations performed on applicants who were never hired further increases the cost of a medical preemployment examination program.
mesh_terms: D000041:Absenteeism; D003365:Costs and Cost Analysis; D004651:Employment; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009786:Occupational Health Services; D009787:Occupational Medicine; D010808:Physical Examination; D013647:Task Performance and Analysis; D013689:Telephone; D014481:United States