Encounter patterns and worker absenteeism/presenteeism among healthcare providers in Thailand

Background We examined the characteristics of healthcare providers’ (HCPs) encounters, and the frequency of worker absenteeism/presenteeism, among HCPs in inpatient wards at a tertiary-level public hospital in Bangkok, Thailand. The wards were stratified by risk of respiratory virus transmission: low-risk (Surgery, Rehabilitation, Orthopedic, and Obstetrics and Gynecology) and high-risk (Medicine, Pediatric, Emergency, and Ear, Nose, and Throat) .

Methods

Observers followed HCPs throughout one self-selected 8-hour work shift to record their interaction with others. An encounter was defined as a 2-way conversation with ≥3 words in the physical presence of ≥1 person at <3 feet distance; or a physical skin-to-skin touch. We administered structured questionnaires to document demographics, health and work history, past practice while ill, and recent and current acute muscle pain and/or respiratory symptoms. We collected data from time and attendance records of participants reporting illness within the past seven days.

Results

From July to August 2019, 240 HCPs were enrolled and observed during 395 work shifts; 15,878 total encounters were made with a median duration of two minutes (interquartile range, 1–3). Number of contacts ranged from 25 to 49 encounters/8 h in the low-risk wards and 40 to 66 encounters/8 h in the high-risk wards. Physicians working during the 8-hour evening shift in high-risk wards had the highest estimated number of contacts (66 encounters; 95% confidence interval [CI], 43–89) while nurses working during the 8-hour night shift in the low-risk wards had the lowest number of contacts (25 encounters; 95% CI, 22–28). Forty-two (11%) shifts were staffed by HCPs with acute muscle pain and/or respiratory symptom(s) at the time of interview, and 89 (23%) by HCPs who reported symptom(s) during the past seven days, for which none were absent from work.

Conclusion

We observed difference in encounter patterns by ward type. About one in five work shifts were staffed by HCPs with acute muscle pain and/or respiratory symptoms who continued to work while ill. These findings have implications for preventing infectious disease transmission and the policy around sick leave in healthcare settings.