title: Cost-effectiveness of sick leave policies for health care workers with influenza-like illness, Brazil, 2009.
abstract: We describe the effect of influenza-like illness (ILI) during the outbreak of pandemic (H1N1) 2009 on health care worker (HCW) absenteeism and compare the effectiveness and cost of 2 sick leave policies for HCWs with suspected influenza. We assessed initial 2-day sick leaves plus reassessment until the HCW was asymptomatic (2-day + reassessment policy), and initial 7-day sick leaves (7-day policy). Sick leaves peaked in August 2009: 3% of the workforce received leave for ILI. Costs during May-October reached R$798,051.87 (≈US $443,362). The 7-day policy led to a higher monthly rate of sick leave days per 100 HCWs than did the 2-day + reassessment policy (8.72 vs. 3.47 days/100 HCWs; p<0.0001) and resulted in higher costs (US $609 vs. US $1,128 per HCW on leave). ILI affected HCW absenteeism. The 7-day policy was more costly and not more effective in preventing transmission to patients than the 2-day + reassessment policy.
authors.affiliation: Hospital das Clínicas, São Paulo, Brazil.
authors.forename: Nancy Val y Val P
authors.initials: NV
authors.lastname: Mota
authors.forename: Renata D
authors.initials: RD
authors.lastname: Lobo
authors.forename: Cristiana M
authors.initials: CM
authors.lastname: Toscano
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Pedroso de Lima
authors.forename: M Beatriz
authors.initials: MB
authors.lastname: Souza Dias
authors.forename: Helio
authors.initials: H
authors.lastname: Komagata
authors.forename: Anna S
authors.initials: AS
authors.lastname: Levin
mesh_terms: D000041:Absenteeism; D001938:Brazil / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D004196:Disease Outbreaks / Q000191:economics; D006282:Health Personnel; D006291:Health Policy / Q000191:economics*; D006784:Hospitals, Teaching / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000191:economics* / Q000453:epidemiology* / Q000517:prevention & control; D018582:Sick Leave / Q000191:economics* / Q000706:statistics & numerical data