Journal of Health, Medicine and Nursing www.iiste.

org
ISSN 2422-8419 An International Peer-reviewed Journal DOI: 10.7176/JHMN
Vol.58, 2019

The Assessment of Causes and Consequences of Medical Staff

Absenteeism and Turnover in Arba Minch General Hospital
Tekle Dula1 Gudata Abara2 Dr. P.A.K. Reddy3
1.Trade and Industry Department, Gamo Gofa Zone, Arbaminch, Southern Ethiopia
2.Wollega University, College of Business and Economics, Department of Accounting and Finance, Ethiopia
3.Wollo University, College of Business and Economics, Department of Accounting and Finance, Ethiopia

Abstract
The purpose of this study is to assess the causes of medical staff absenteeism and turnover in case of Arbaminch
General Hospital. In addition, it explores the consquences/ impact of absenteeism and trunover on patients
care,workload on medical staff and reputation on Arbaminch General Hospital. To this end, the study employed
a descriptive, correlation and regession analysis. Data was collected using closed ended structured questionnaires
by applying Likert scale which were filled by full time medical staff (N= 50). The findings indicate that
demographic factors such as marital status, working experiences, educational level and have significant negative
correlation with absenteeism and turnover. Organizational factors such as working condition and work load have
positive significant correlation with medical staff absenteeism and turnover. In contrast, all studied
organizational factors such as compensation/ incentive program, promotional opportunities, managerial style,
training and development and career development are significantly negatively correlated with both absenteeism
and turnover. The findings also indicated that medical staff absenteeism and turnover had consequences on
patient care, increasing workload on existing staff, and bad reputation for hospital. Furthermore, both
absenteeism and turnover have resulted in demoralization of existing medical staff at Arbaminch General
Hospital.
Keywords: Demographic Variables, Job Factors, Organizational Factors, Patient Care, Demoralization,
Absenteeism, Turnover
DOI: 10.7176/JHMN/58-04

I. INTRODUCTION
Employee turnover is expensive from the view of the organization. Voluntary quits which represents mass
departure of people of human capital investment from organizations and the subsequent replacement process
entails manifold costs to the organizations. These replacement costs include for example, search of the external
labor market for a possible substitute, selection between competing substitutes, induction of the chosen substitute,
and formal and informal training of the substitute until he or she attains performance levels equivalent to the
individual who quit. Addition to these replacement costs, output would be affected to some extend or output
would be maintained at the cost of overtime payment (John 2000). According to Hacker (1999) when an
employee leaves, other employees who were sociable with the leaver may feel distressed. If leavers are valuable
co-workers, and/or if the work group is cohesive, turnover can have a negative effect on those remaining.

Statement of the problem

From the national and international literature, it is evident that medical staff absenteeism and turnover is a
problematic issue. The study will observe tendency to medical staff absenteeism and turnover on governmental
hospital. Absenteeism and turnover are obvious among staff and the factors that are playing in a Government
Hospital of Arbaminch have not been investigated and documented formally. The study is employed to assess
the causes and impact of absenteeism and turnover in Arbaminch general Hospital. The specific reasons for
absenteeism and turnover of the medical staff in this Government Hospital are not assessed and unclear. The
causes could be followings. First, demographic factors such as age, gender, educational status, marital status,
tenure. Second, job related factors such as work load, working conditions, and routine work. Third,
organizational factors including incentives programs, promotional opportunities, managerial style, training and
development. Both the medical staff and the patients in this hospital experience the consequences of poorly
managed absenteeism and turnover.
The staff turnover and absenteeism have the following impacts on hospital performance:
First, existing medical staff will have increased workload and get demoralized if absenteeism and turnover is
frequent.
Second, the patients care service quality is also impacted if absenteeism and turnover.
Generally, organization has planned to serve the number of patients daily based on the employees’ number.
Absenteeism and Losing the critical employees (qualified) and experienced medical staff professionals’
leads to negatively affect the productivity (effectiveness) of healthcare organization in a various ways, such
as demoralization of existing staff, decrease quality of patient care.

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ISSN 2422-8419 An International Peer-reviewed Journal DOI: 10.7176/JHMN
Vol.58, 2019

In order to solve the aforementioned problems the following questions are raised:
What are the causes of absenteeism and turnover in Arbaminch general hospital?
What are the consequences of medical staff absenteeism and turnover in the hospital under consideration?
To what extent absenteeism and turnover affect patients care?
To what extent

Objectives of the study

The general objective of the study is to assess the causes and consequences of medical staff absenteeism and
turnover in Arbaminch General Hospital.
To attain the above general objective, there are specific objectives that need to be studied in the case of
Arbaminch General Hospital. These are as follows:
To assess causes of absenteeism and turnover in Arbaminch general hospital.
To examine consequences of absenteeism and turnover on hospital performance.
To analyze the impact of absenteeism and turnover on patient care.
To foresee the impact of workplace absenteeism and turnover on morale of existing medical staffs.
Provide possible recommendation that can cause work places absenteeism and turnover

Significance of the Study

Governmental and public sector organizations success can be measured mainly through delivery of quality
service to their beneficiaries. This can be achieved through well formulated plans and programs, allocation of
resources, assignment and retention of committed and competent staffs. Therefore, the researcher is highly aware
of that the results of this study have the following significance for different bodies:
• It will help public hospital to understand the causes and impact of absenteeism and turnover affects
organizational performances. This helps the management to create awareness on absenteeism and turnover
causes and consequences.
• The researcher will get knowledge and understanding regarding assessing the absenteeism and turnover
employees.
• It serves as base for interested researchers as a reference on the issue in conducting future and detail study
in the area.
• Furthermore, the study will put contribution for University’s research and development purpose
• The study will certain be a key indicator for sustainability of the staff with judicious welfare of the all stake
holders toward betterment and competitiveness’ of medical services in Ethiopia.

II. MATERIALS AND METHODS

The population for this study is permanent medical professionals working in the Arbaminch General Hospital
totally 229. This includes all categories of medical staff namely specialist, general practitioner, health officers,
all nurses’ pharmacist, laboratory technology and assistant, sanitary, optical, Anastasia and X-ray, enrolled in
hospital. Out of this, total number of female is 46.67% (100) and male is 53.33 %( 127). Of this total population,
the sample size selected for this study is 20℅ (50) to provide the required information. The sampling was
compiled by means of a stratifying random sampling techniques this is due to the fact that each group of medical
staffs have different professional field of studied/level of education and areas of specialization which help to
collect data from them as per their views, knowledge and to what extent absenteeism and turnover affects the
operational activities of the Hospital. The strata of total selected sample size are 20℅ specialist, 20℅ general
practitioner, 20℅ health officer, 20℅ all nurses, 20℅ pharmacist technology and assistant, 20℅ laboratory
technology and assistant, 20℅ optical 20℅ anesthesia and 20℅ X- ray with totally size of 50 in number those
who are currently acting on their job. To do so the questionnaire paper were given to employee and fulfilled the
necessary information. Data collection was made using appropriate methods to meet the specific objectives of
the study. In the first phase of the study, the survey will be conducted on the employees through the use of close
ended questionnaires. The material is in a Likert Scale form which gives the details to the researcher on the
perception of the employees on absenteeism and turnover to provide the findings of the study. It was used to
obtain their view about the causes and consequences of absenteeism and turnover on organizational performance.
Descriptive statistics and inferential Statistical such as correlation and regression analysis were used for analysis.
In addition, program of Statistical Packaging for Social Sciences (SPSS) was also used.

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Journal of Health, Medicine and Nursing www.iiste.org
ISSN 2422-8419 An International Peer-reviewed Journal DOI: 10.7176/JHMN
Vol.58, 2019

III. RESULTS AND DISCUSSION

Relationship analysis of medical staff absenteeism and turnover in Arbaminch General Hospital
The correlation analysis of Demographic factors with absenteeism and turnover
Table 1. The Pearson correlation matrix analysis between demographic variables with medical staff’s
absenteeism and turnover
Dependent variables
Independent variables Absenteeism Turnover
Gender of respondent r p r p
.155 .281 .103 .476
Marital status of respondent -.396** .004 -.706** .000
Level of educational qualification -.386** .006 -.462** .001
Age of respondent -.323* .022 -.433** .002
Working experiences of respondent -.294* .038 -.496** .002
From the above table 1, correlation analysis, where r is to show the relationship between gender and
absenteeism at Pearson correlation of r =0.155. Also it show the relationship between gender and turnover
indicated by the Pearson correlation r = 0.103 at (p value .281 and .476) for both absenteeism and turnover
respectively where p value is > at significant level.05, therefore gender has insignificant relationship for
absenteeism and turnover among medical staff in Arbaminch General Hospital.
Based on above correlation table 1 as the results shows the relationship between marital status in
organization and absenteeism at Pearson correlation of r= -.396**where p value was .004 which is less than the
significant level of .05. This indicated that there is negative relationship between marital status and absenteeism.
In addition, the correlation results indicated that at Pearson correlation (r = -.706** p values at .000 ) for marital
status and turnover where p value is less than significant level.01, which means there is strong negative
relationship between marital status and turnover among medical staff in Arbaminch General Hospital. The
implication of the above data indicates that the marital status of medical staffs is strong relationship for
absenteeism and turnover. This means that as one employee married he/she is attached to the organization and
interested to work for the hospital to pursue the organizational goals.
Therefore the finding indicated that as married employee less sensitive to absenteeism and turnover than
single. If married employees are more, the level of absenteeism and turnover among medical staff tend to
decreases.
From the above table 1 the correlation matrix analysis results shows the relationship between level of
educational qualification and absenteeism at Pearson correlation of r= -.386**. It Also shows the relationship
between level of educational qualification and turnover indicated by the Pearson correlation r = -.462**at (p
value.006 and .001) for level of education with absenteeism and turnover respectively where p value is less than
significant level.05. Therefore, the level of educational qualification has significant negative relationship with
absenteeism since p value is less than significant level .01. There is also strong negative significant relationship
between level of educational qualification and turnover of medical staff in Arbaminch General Hospital this
means as level of educational qualification increases the tendency to be absent and tend to leave the organization
decreases.
From the above table 1 the correlation matrix analysis results shows the relationship between Age and
absenteeism at Pearson correlation of r= -.323* It Also shows the relationship between Age and turnover
indicated by the Pearson correlation r -.433** (p value 0.022and .002) for age with absenteeism and turnover
respectively where p value is less than significant level.05. Therefore, the Age has significant negative
relationship with absenteeism since p value is less than significant level .01. There is also strong negative
significant relationship between Age and turnover of medical staff in Arbaminch General Hospital. Hence as age
increases the tendency to be absent and tend to leave the organization decreases.
The correlation matrix analysis between working experience in organization with medical staff absenteeism
and turnover based on above correlation table 1 the results shows the relationship between working experiences
in organization and absenteeism at Pearson correlation of r= -.294* where p value was 0.038 which is less than
the significant level of .05. This indicated that there is negative relationship between working experience and
absenteeism. In addition, the correlation results indicated that at Pearson correlation (r = -.496**, p values
at .002 ) for working experience and turnover where p value is less than significant level.01, which means there
is strong negative relationship between working experiences and turnover among medical staff in Arbaminch
General Hospital. Therefore the finding indicated that as working experience/ services year increases, the level
of absenteeism and turnover among medical staff tend to decreases. Based on finding in general all demographic
variables except gender have negative significant relationship with both absenteeism and turnover in Arbaminch
General Hospital.

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ISSN 2422-8419 An International Peer-reviewed Journal DOI: 10.7176/JHMN
Vol.58, 2019

Relationship between absenteeism and turnover with job related variables (working condition, workload
and routine work.
Table 2. Pearson correlation analysis results of relationship between job factors with absenteeism and
turnover.
Dependent variables
Demographic variables Absenteeism Turnover
r p r p
Working condition on hospital .337* .017 .532** .000
Workload on medical staff .662** .000 .594*** .000
Routine work for staff .165 .252 .017 .909
*. Correlation is significant at the 0.05 level (2-tailed).
**. Correlation is significant at the 0.01 level (2-tailed).
Based on above correlation table 2 as the results shows relationship between working condition and
absenteeism at Pearson correlation of r= .337*where p value was .017 which is less than the significant level
of .05. This indicated that there is positive relationship between working condition and absenteeism. In addition,
the correlation results indicated that at Pearson correlation (r = .532**, p values at .000) for working condition
and turnover where p value is less than significant level.01, which means there is strong positive relationship
between working condition and turnover for medical staff in Arbaminch General Hospital. Therefore the finding
indicated that as working condition being unsafe and, poor which exposes professional be absent from work and
tends to leave organization.
From the above table 2 the correlation matrix analysis results show the relationship between workload and
absenteeism at Pearson correlation of r. 662**. It Also shows the relationship between level of workload and
turnover indicated by the Pearson correlation r = .594***at (p value.000 and .000) for workload with absenteeism
and turnover respectively where p value is less than significant level.01. Therefore, workload has significant
strong positive relationship with absenteeism since p value is less than significant level .01. There is also strong
positive significant relationship between workload and turnover of medical staff in Arbaminch General Hospital
i.e. medical staff is absent from work and prepare to leave organization. Also the correlation matrix analysis
results from the above table 2 show the relationship between routine work and absenteeism at Pearson
correlation of r= .165 in addition to show the relationship between routine work and turnover indicated by the
Pearson correlation r = .017 at (p value .252 and 0.909) for both absenteeism and turnover with routine work
respectively where p value is greater than at p significant level.05 value. Therefore the routine work has
insignificant relationship both absenteeism and turnover in organization. So it is not related to be absent and
leaving from organization.
Based on finding all job factors/work related variable except routine work have positive significant
relationship with both absenteeism and turnover in Arbaminch General Hospital.
Relation between organizational factors with absenteeism and turnover
Table 3. Pearson correlation analysis of the relationship between organizational factors with medical
staff’s absenteeism and turnover
Dependent variables
Independent variables Absenteeism Turnover
R p r P
Incentive program for medical staff -.352** 0.020 -.480** 0.000
Promotional opportunity for -.250* .0.040 -.497** 0.000
medical staff
Managerial style to medical staff -.316* 0.025* -.474** 0.000
**
Training and development for medical staff -.505 0.000 -.597** .000
Career development for medical staff -.519** .000 -.571** .000
**. Correlation is significant at the 0.01 level (2-tailed).
*. Correlation is significant at the 0.05 level (2-tailed).
From the above table 3 the correlation matrix analysis results shows the relationship between incentive
program/compensation and absenteeism at Pearson correlation of r=-.352** it Also shows the relationship
between incentive program/compensation and turnover indicated by the Pearson correlation r= -.480** (p
value.020 and .000) for incentive program/compensation with absenteeism and turnover respectively where for p
value is less than significant level.05. Therefore, the incentive program/compensation has significant negative
relationship with absenteeism since p value is less than significant level .01. There is also strong negative
significant relationship between incentive program/compensation and turnover of medical staff in Arbaminch
General Hospital thus turnover is more negatively related incentive program/compensation than absenteeism in
organization.

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ISSN 2422-8419 An International Peer-reviewed Journal DOI: 10.7176/JHMN
Vol.58, 2019

From the above table 3, the correlation matrix analysis results shows the relationship between Promotional
opportunity for medical staff and absenteeism at Pearson correlation of r= -.250**. It also shows the relationship
between promotional opportunity of medical staff and turnover indicated by the Pearson correlation r = -.497**
and the p value (p value.0.040 and .000) of promotional opportunity for medical staff with absenteeism and
turnover respectively whereas p value is less than significant level.05 with absenteeism and less than 0.01 with
turnover. Therefore, the promotional opportunity for medical staff is negative significant relationship with
absenteeism since p value is less than significant level .05. There is also strong negative significant relationship
between promotional opportunity for medical staff and turnover of medical staff in Arbaminch General Hospital
because p value is less than significant level .01 i.e. turnover is more negatively related promotional opportunity
than absenteeism in the hospital.
Based on above correlation table 3 as the results shows the relationship between managerial style to medical
staff and absenteeism at Pearson correlation of r-.316 where p value was 0.025 which is less than the significant
level of p value .05. This indicated that there is negative relationship between managerial style and absenteeism.
In addition, the correlation results indicated that at Pearson correlation (r -.474**p values at .000 ) for managerial
style and turnover where p value is less than significant level.01 this means there is strong negative relationship
between managerial style s and turnover of medical staff in Arbaminch General Hospital. Therefore the finding
indicated that the relationship between managerial style with absenteeism and turnover are inversely related and
medical staff is more sensitive to ward managerial style. Also it was explained by researcher such as (Gerber,
1998) found that Nurse Managers need to motivate their nursing staff by using power, but misuse of power
adversely lowers nurse’s morale, which in turn could lead to their absenteeism on other hand also if relationship
medical staff means participatory Managers should foster initiative and responsibility by allowing staff to
participate in decision making. This boosts staff confidence, increases self-efficacy and therefore reduces
absenteeism (Laschinger et al.1997) in contrast the relationship between managers to medical staff is negative
means it is not participatory on decision making it may lead medical staffs not retain and absent from work.
Based on above correlation table 3.3 as the results shows the relationship between training and development
for medical staff and absenteeism at Pearson correlation of r= -.505* where p value was 0.000 which is less than
the significant level of .01. This indicated that there is strong negative relationship between training and
development for medical staff and absenteeism. In addition, the correlation results indicated that at Pearson
correlation (r = -.597**, p values at .002 ) for training and development for medical staff and turnover where p
value is less than significant level.01, which means there is strong negative relationship between training and
development for medical staff and turnover of medical staff in Arbaminch General Hospital. Therefore the
finding indicated that as training and development is important points that inversely relate to absence and
retention to medical staff on Arbaminch General Hospital.
Also correlation results indicated on table 3 the relationship between career development and absenteeism
with r =-.519* p = -.000 with results indicate that where p value is less than at significant value /level 0.01 Hence
career development has significant negative relationship with absenteeism .In addition, there is based on the
correlation results, the relationship between career development and turnover at Pearson correlation of r = -.571*
and p = .000 which is less than the significant level of 0.01 which means career development is strong negative
significant relationship with turnover. In general all five important organizational variables have negative
significant relationship with absenteeism and turnover and more strong inversely related with turnover.
Regression analysis of demographic, job and organizational factors with absenteeism and turnover.
Table: 4. Regression of demographic, job and organizational factors on absenteeism and turnover
Absenteeism Turnover
Causes P R R2 P R R2
Marital status .004 .396 .157 .000 .706 .498
Age .022 .323 .104 .002 0.433 0.187
Educational level .006 .386 .149 .001 0.462 0.213
Working experience .029 0.308 0.09 5 .000 .525 .276
Workload .000 .662 .439 .000 .594 .353
Working conditions .017 .337 .113 .000 .532 .283
Incentive programs 0.02 .327 .107 .000 .250 .063
Promotional opportunities .040 .250 .063 .000 .497 .247
Managerial style .001 .447 .199 .000 .603 .364
Training and development .000 .505 .255 0.00 .597 .356
Career development .000 .519 .269 .000 .571 .326

IV. CONCLUSION
Based on the results of findings the following conclusions were made:
The results revealed that among the demographic factors/variables gender has insignificant correlation with

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Journal of Health, Medicine and Nursing www.iiste.org
ISSN 2422-8419 An International Peer-reviewed Journal DOI: 10.7176/JHMN
Vol.58, 2019

absenteeism and turnover. Whereas age, educational level, marital status and experience of medical staffs have a
negative correlation with absenteeism and turnover in Arbaminch General Hospital.
Among the job factors, working conditions and workload have positive relationship with absenteeism and
turnover. Conversely, routine of work has no relationship with absenteeism and turnover.
The findings also explained that all the organizational factors, incentive programs,/compensation,
promotional opportunities, training and development, managerial style, career development have significant
negative relationship with dependent variables; absenteeism and turnover.
Absenteeism and turnover of medical staffs have a consequence on the hospital performance. This leads the
hospital to lose its reputation the potential customers or patients may turn back towards other hospitals for
getting good care.
Absenteeism and turnover of medical staffs have significant impact on the patient care in Arbaminch
General Hospital. This means as the medical staffs become absent from their work and leave the organization;
the quality of patient care tends to decrease.
Absenteeism and turnover of medical staffs have impact on the morale of the existing staffs. This shows
that when the medical staffs do not commit to their work, the other existing staff will be demoralized as they are
overloaded. In addition, if the medical staffs leave the hospital the existing/remaining workers feel that they will
be demoralized.

Implication of future study

This study focused on one Governmental hospital. The finding also indicates the causes and consequences of
absenteeism and turn over in Hospital. This is difficult to say in every hospital the factors are limited to these. So,
the future researchers can conduct the same problems by adding other variables in addition to these explained in
this study. In addition, the study dealt with the primary data collected from the respondents. In this case this will
help to solve the qualitative data. But it is good to add secondary data especially on the impact of absenteeism
and turnover on the hospital performance. This will solve the cost-effectiveness in dealing with absenteeism and
turnover problems.

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